Provider Demographics
NPI:1003014978
Name:MILLER, MELISSA (LMT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 W GIACONDA WAY STE 103
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-4341
Mailing Address - Country:US
Mailing Address - Phone:520-858-0350
Mailing Address - Fax:520-448-0819
Practice Address - Street 1:231 W GIACONDA WAY STE 103
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-4341
Practice Address - Country:US
Practice Address - Phone:520-858-0350
Practice Address - Fax:520-448-0819
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
172M00000X, 174400000X, 225400000X
WAMA00019851225700000X
AZM23522225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No172M00000XOther Service ProvidersMechanotherapist
No174400000XOther Service ProvidersSpecialist
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner