MEDICARE: MISS MELISSA MARIE CONTESTABILE 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	33.010007	OH

General Provider Information

NPI Number	:	1912775560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MELISSA MARIE CONTESTABILE LMT

Provider Business Mailing Address
First Line	:	9140 E MARKET ST
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44484-5520
Country	:	US
Telephone Number	:	330-720-8961
Fax Number	:

Provider Business Practice Location Address
First Line	:	1206 E MARKET ST
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44483-6606
Country	:	US
Telephone Number	:	330-394-7246
Fax Number	:

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

Provider Enumeration Date	:	12/13/2023
Last Update Date	:	12/13/2023

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