Individual
JOHNATHON MELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14028 N HWY 183 STE D120, AUSTIN, TX 78717-5992
(512) 250-8800
Mailing address
2000 S LAKELINE BLVD APT 436, CEDAR PARK, TX 78613-3915
(830) 305-0735
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT111929
MASSAGE THERAPY
TX
Enumeration date
09/26/2017
Last updated
09/26/2017
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