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NPI Code Detail

MEDICARE: MELISSA R LEE

MEDICARE:   MELISSA R LEE
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
1225700000XMassage Therapist6732SC

General Provider Information

NPI Number : 1457031197
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA R LEE
Provider Business Mailing Address
First Line : 2742 ETON ST
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29579-6714
Country : US
Telephone Number : 843-685-0346
Fax Number :
Provider Business Practice Location Address
First Line : 2742 ETON ST
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29579-6714
Country : US
Telephone Number : 843-685-0346
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2023
Last Update Date : 07/18/2023

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Directions to “ MELISSA R LEE ” Practice Location

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