Provider Demographics
NPI:1568775401
Name:RYAN, MELISSA A (LMT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:RYAN
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 1:141 BRADY CIR W
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-1411
Mailing Address - Country:US
Mailing Address - Phone:740-317-2219
Mailing Address - Fax:
Practice Address - Street 1:141 BRADY CIR W
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-1411
Practice Address - Country:US
Practice Address - Phone:740-317-2219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33014123225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH33014123OtherSTATE LICENSE
WV2005-1657OtherMASSAGE THERAPY BOARD