MEDICARE: MELODY PAYNE LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MT.0001214	CO

General Provider Information

NPI Number	:	1679016653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELODY PAYNE LMT

Provider Business Mailing Address
First Line	:	3495 W 115TH AVE
Second Line	:
City	:	WESTMINSTER
State	:	CO
Zip	:	80031-7100
Country	:	US
Telephone Number	:	303-669-0543
Fax Number	:

Provider Business Practice Location Address
First Line	:	3495 W 115TH AVE
Second Line	:
City	:	WESTMINSTER
State	:	CO
Zip	:	80031-7100
Country	:	US
Telephone Number	:	303-669-0543
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2016
Last Update Date	:	11/23/2016

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Directions to “ MELODY PAYNE LMT” Practice Location

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