Healthcare Provider Details

I. General information

NPI: 1861487928
Provider Name (Legal Business Name): MELISSA HUEY ATC, LAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 11/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E BUSINESS WAY SUITE C
CINCINNATI OH
45241-2374
US

IV. Provider business mailing address

10830 ARCARO LN
UNION KY
41091-9201
US

V. Phone/Fax

Practice location:
  • Phone: 513-389-3665
  • Fax:
Mailing address:
  • Phone: 859-746-3118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number36001067A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: