Provider Demographics
NPI:1760760524
Name:BENSON, MELAYNA KAY (CMT)
Entity Type:Individual
Prefix:MRS
First Name:MELAYNA
Middle Name:KAY
Last Name:BENSON
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44916 HAYS ST
Mailing Address - Street 2:
Mailing Address - City:RUSHFORD
Mailing Address - State:MN
Mailing Address - Zip Code:55971-5082
Mailing Address - Country:US
Mailing Address - Phone:507-864-8082
Mailing Address - Fax:
Practice Address - Street 1:44916 HAYS ST
Practice Address - Street 2:
Practice Address - City:RUSHFORD
Practice Address - State:MN
Practice Address - Zip Code:55971-5082
Practice Address - Country:US
Practice Address - Phone:507-864-8082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-28
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist