Provider Demographics
NPI:1427924133
Name:TRUELOVE-BOYLAN, MELISSA LEIGH (MT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:LEIGH
Last Name:TRUELOVE-BOYLAN
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1824 SAND HILL RD
Mailing Address - Street 2:
Mailing Address - City:GUYTON
Mailing Address - State:GA
Mailing Address - Zip Code:31312-5220
Mailing Address - Country:US
Mailing Address - Phone:817-683-5975
Mailing Address - Fax:
Practice Address - Street 1:117 W HENDRY ST UNIT 141
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-3272
Practice Address - Country:US
Practice Address - Phone:912-570-5105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-11
Last Update Date:2025-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT014434225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist