Provider Demographics
NPI:1023461142
Name:SCHULTZE, MELISSA JANE (LMT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:JANE
Last Name:SCHULTZE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:JANE
Other - Last Name:PAVLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:2667 NORTHRUP PL
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4122
Mailing Address - Country:US
Mailing Address - Phone:907-727-2500
Mailing Address - Fax:
Practice Address - Street 1:751 E 36TH AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-4166
Practice Address - Country:US
Practice Address - Phone:907-929-7818
Practice Address - Fax:907-929-7861
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist