Provider Demographics
NPI:1073347753
Name:YODER, MELISSA MURSET (LMT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MURSET
Last Name:YODER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:LYNN
Other - Last Name:MURSET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:208 N BEACON DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-2254
Mailing Address - Country:US
Mailing Address - Phone:435-592-4264
Mailing Address - Fax:
Practice Address - Street 1:1870 N MAIN ST STE 104
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84721-7740
Practice Address - Country:US
Practice Address - Phone:435-704-1622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4910410-4701225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist