Healthcare Provider Details

I. General information

NPI: 1609017227
Provider Name (Legal Business Name): MELISSA L TVETE AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2009
Last Update Date: 03/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S BRUCE ST
MARSHALL MN
56258-1934
US

IV. Provider business mailing address

300 S BRUCE ST
MARSHALL MN
56258-1934
US

V. Phone/Fax

Practice location:
  • Phone: 507-532-2687
  • Fax: 507-537-9190
Mailing address:
  • Phone: 507-532-2687
  • Fax: 507-537-9190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number8449
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: