# MELSTROM FAMILY FUNCTIONAL WELLNESS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669334165
- **Authorized official:** RYNE MELSTROM (MEMBER)
- **Authorized official phone:** (928) 303-2508

## Contact information

- **Practice address:** 2247 S BENTON, MESA, AZ 85209-1583
- **Practice address phone:** (928) 303-2508
- **Mailing address:** 2247 S BENTON, MESA, AZ 85209-1583

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 124Q00000X | Dental Hygienist | — | NULL | Yes |
| 124Q00000X | Dental Hygienist | — | — | Yes |

## Other

- **Enumeration date:** 12/02/2025
- **Last updated:** 12/02/2025