Healthcare Provider Details

I. General information

NPI: 1790137339
Provider Name (Legal Business Name): MELANIE CHARLEY DACM AND LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELANIE HOBBS

II. Dates (important events)

Enumeration Date: 07/07/2016
Last Update Date: 05/01/2023
Certification Date: 05/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5313 ARCTIC BLVD
ANCHORAGE AK
99518-1111
US

IV. Provider business mailing address

305 SKWENTNA DR
ANCHORAGE AK
99504-4887
US

V. Phone/Fax

Practice location:
  • Phone: 907-960-1661
  • Fax: 907-313-1534
Mailing address:
  • Phone: 907-960-1661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number195146
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number107487
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: