Individual
SARA MELLADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CST
Contact information
Practice address
1345 UNITY PL STE 225, LAFAYETTE, IN 47905-5762
(765) 449-2436
(765) 449-1817
Mailing address
PO BOX 4699, LAFAYETTE, IN 47903-4699
(765) 446-5417
(765) 446-5317
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
161755
IN
Other
Enumeration date
09/07/2018
Last updated
09/07/2018
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