Provider Demographics
NPI:1164716411
Name:NOISE, MELANIE (FITNESS INSTRUCTOR)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:NOISE
Suffix:
Gender:F
Credentials:FITNESS INSTRUCTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 35229
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-0229
Mailing Address - Country:US
Mailing Address - Phone:804-592-4751
Mailing Address - Fax:804-592-4752
Practice Address - Street 1:8014 MIDLOTHIAN TPKE
Practice Address - Street 2:SUITE 200 -A
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-5291
Practice Address - Country:US
Practice Address - Phone:804-592-4751
Practice Address - Fax:804-592-4752
Is Sole Proprietor?:No
Enumeration Date:2011-06-03
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor