Healthcare Provider Details

I. General information

NPI: 1891134284
Provider Name (Legal Business Name): MELISSA ANN HAHN CMT, CR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2013
Last Update Date: 08/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 2ND ST S
BUFFALO MN
55313-1413
US

IV. Provider business mailing address

109 2ND ST S
BUFFALO MN
55313-1413
US

V. Phone/Fax

Practice location:
  • Phone: 763-684-4646
  • Fax:
Mailing address:
  • Phone: 763-684-4646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: