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General NPI Number Information
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NPI Number | 1285816199
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Entity Type | Individual
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Provider Name | MELISSA MARIE MILLS MASSAGE THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 12/03/2007
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Last Update Date | 10/31/2008
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Provider Practice Location Address
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Address Line | 205 E DIMOND BLVD #235
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City | ANCHORAGE
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State | AK
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Zip | 99515-1909
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Country | US
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Telephone | 907-223-0635
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Fax |
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Provider Business Mailing Address
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Address Line | 8420 STACEY CIR
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City | ANCHORAGE
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State | AK
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Zip | 99507-3669
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Country | US
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Telephone | 907-223-0635
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 1562
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License Number State | AK
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