Individual
MELINDA MICHELE COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2322 D AVE NE, CEDAR RAPIDS, IA 52402-4921
(319) 321-1576
Mailing address
2322 D AVE NE, CEDAR RAPIDS, IA 52402-4921
(319) 321-1576
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
005798
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
775ZZ6780
DRIVER LICENSE
IA
Enumeration date
04/26/2019
Last updated
04/26/2019
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