Healthcare Provider Details

I. General information

NPI: 1801134333
Provider Name (Legal Business Name): MELANIE LYNN MILLS-JUHASZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2013
Last Update Date: 01/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1485 STATE ROUTE 44 UNIT D
ATWATER OH
44201-9267
US

IV. Provider business mailing address

PO BOX 444
RANDOLPH OH
44265-0444
US

V. Phone/Fax

Practice location:
  • Phone: 330-325-7390
  • Fax: 330-325-7390
Mailing address:
  • Phone: 330-603-0959
  • Fax: 330-325-7063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33.020660-L
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: