Provider Demographics
NPI:1972227536
Name:ONEILL, MELANIE (MSAT, ATC, LAT)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:ONEILL
Suffix:
Gender:F
Credentials:MSAT, ATC, LAT
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:O'NEILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSAT, ATC, LAT
Mailing Address - Street 1:6965 CUMBERLAND GAP PKWY
Mailing Address - Street 2:
Mailing Address - City:HARROGATE
Mailing Address - State:TN
Mailing Address - Zip Code:37752-8231
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6965 CUMBERLAND GAP PKWY
Practice Address - Street 2:
Practice Address - City:HARROGATE
Practice Address - State:TN
Practice Address - Zip Code:37752-8231
Practice Address - Country:US
Practice Address - Phone:423-869-3611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-28
Last Update Date:2024-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLAT-56682255A2300X
TN32532255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer