National Provider Identifier
Misty Melissa Fearon, PT
Misty Melissa Fearon, PT is listed in the NPPES registry with a primary specialty of Physical Therapist in Ithaca, NY and a listed phone number of (607) 277-8020.
Profile Overview
- NPI
- 1922138148
- Provider Type
- Individual
- Primary Specialty
- Physical Therapist
- Enumeration Date
- March 06, 2007
- Last Updated
- March 01, 2011
Practice Location
- 1001 W Seneca St
- Suite 100
- Ithaca, NY 14850-3342
Phone: (607) 277-8020
Specialties
- Physical Therapist (225100000X)
- Physical Therapist (225100000X)
Full Record
- NPI
- 1922138148
- Entity Type
- Individual
- Last Name
- Fearon
- First Name
- Misty
- Middle Name
- Melissa
- Credential
- PT
- Provider Other Last Name
- Morris
- Provider Other First Name
- Misty
- Provider Other Middle Name
- Melissa
- Provider Other Credential Text
- PT
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 1001 W Seneca St
- Mailing Address Line 2
- Suite 100
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-3342
- Mailing Country
- US
- Mailing Phone
- (607) 277-8020
- Mailing Fax
- (607) 277-7961
- Practice Street Address
- 1001 W Seneca St
- Practice Address Line 2
- Suite 100
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-3342
- Practice Country
- US
- Practice Phone
- (607) 277-8020
- Practice Fax
- (607) 277-7961
- Enumeration Date
- March 06, 2007
- Last Updated
- March 01, 2011
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physical Therapist (225100000X), Physical Therapist (225100000X)