Provider Demographics
NPI:1902060262
Name:MELSON CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:MELSON CHIROPRACTIC, INC.
Other - Org Name:CHIROPRACTIC HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:MELSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:513-793-4300
Mailing Address - Street 1:4771 GLENDALE MILFORD RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-3819
Mailing Address - Country:US
Mailing Address - Phone:513-793-4300
Mailing Address - Fax:513-469-1880
Practice Address - Street 1:4771 GLENDALE MILFORD RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-3819
Practice Address - Country:US
Practice Address - Phone:513-793-4300
Practice Address - Fax:513-469-1880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1234111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME9328371Medicare PIN