Provider Demographics
NPI:1467725671
Name:SACO-VERTIZ, MELISSA LYNN (LMT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:LYNN
Last Name:SACO-VERTIZ
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 1:241 SE 9TH AVE APT 106
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-7336
Mailing Address - Country:US
Mailing Address - Phone:561-654-0007
Mailing Address - Fax:
Practice Address - Street 1:241 SE 9TH AVE APT 106
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-7336
Practice Address - Country:US
Practice Address - Phone:561-654-0007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA61807172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist