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NPI Code Detail

MEDICARE: MRS. MELANIE WOODALL SMITH M.S., CCC-A

MEDICARE:  MRS. MELANIE WOODALL SMITH  M.S., CCC-A
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1237600000XAudiologist-Hearing Aid Fitter003500GA

General Provider Information

NPI Number : 1336394915
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MELANIE WOODALL SMITH M.S., CCC-A
Provider Business Mailing Address
First Line : 705 DALLAS HWY STE 301
Second Line :
City : VILLA RICA
State : GA
Zip : 30180-1243
Country : US
Telephone Number : 770-459-0408
Fax Number : 770-459-1575
Provider Business Practice Location Address
First Line : 705 DALLAS HWY STE 301
Second Line :
City : VILLA RICA
State : GA
Zip : 30180-1243
Country : US
Telephone Number : 770-459-0408
Fax Number : 770-459-1575
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2008
Last Update Date : 11/24/2008

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Directions to “ MRS. MELANIE WOODALL SMITH M.S., CCC-A” Practice Location

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