MEDICARE: MELISSA ANN ANDERSON L.AC

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
1	171100000X	Acupuncturist	5401000266	MI

General Provider Information

NPI Number	:	1699354126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA ANN ANDERSON L.AC

Provider Business Mailing Address
First Line	:	2511 HOWELL HWY
Second Line	:
City	:	ADRIAN
State	:	MI
Zip	:	49221-9301
Country	:	US
Telephone Number	:	517-208-2081
Fax Number	:

Provider Business Practice Location Address
First Line	:	216 E CHICAGO BLVD
Second Line	:
City	:	TECUMSEH
State	:	MI
Zip	:	49286-1549
Country	:	US
Telephone Number	:	517-208-2082
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2021
Last Update Date	:	04/02/2021

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Directions to “ MELISSA ANN ANDERSON L.AC” Practice Location

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