Individual
MELYNDA WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5410 LYNX LN, SUITE 30, COLUMBIA, MD 21044-2376
(301) 327-6466
Mailing address
9200 BRIDLE PATH LN, UNIT H, LAUREL, MD 20723-1545
(301) 327-6466
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
R02450
MD
Other
Enumeration date
02/19/2017
Last updated
02/19/2017
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