Individual
MS. MELISSA LORRAINE WYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
1449 SHORTRIDGE AVE, SAN JOSE, CA 95116-2351
(408) 608-7909
Mailing address
PO BOX 720591, SAN JOSE, CA 95172-0591
(408) 608-7909
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
73052
CA
Other
Enumeration date
10/11/2023
Last updated
10/11/2023
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