Most Relevant Information
Provider Data
| NPI Number: | 1003532151 |
| Provider Name: | MELISSA MICHAEL LMT |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | MT6663 |
Most Important Dates
| Enumeration Date: | 10/19/2022 |
| Last Updated: | 10/19/2022 |
Provider Practice Location
11305 GATEWAY CT
SCARBOROUGH
ME
040745555
Practice Location Phone/Fax
| Phone: | 2077124137 |
| Fax: |
Provider Mailing Location
11305 GATEWAY CT
SCARBOROUGH
ME
040745555
Provider Mailing Phone/Fax
| Phone: | 2077124137 |
| Fax: |