Melissa Kate Merritt, LMT

Individual provider Active NPI Massage Therapist · Avondale Estates, GA

NPI 1962703579 · NPPES record last updated Nov 12, 2010

Key facts

NPI
1962703579
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MT0004156 (GA)
Practice address
12 Berkeley Rd
#2
Avondale Estates, GA 30002-1467
Phone
(404) 920-8492
Fax
(404) 920-8641
NPI assigned
Nov 12, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MT0004156GAMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT0004156 GA Yes

Addresses

Primary practice location

12 Berkeley Rd
#2
Avondale Estates, GA 30002-1467

Mailing address

12 Berkeley Rd
#2
Avondale Estates, GA 30002-1467

Other providers in Avondale Estates, GA

All providers in Avondale Estates, GA · Massage Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.