Provider Demographics
NPI:1033417803
Name:RUPP, MELISSA S (DC)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:S
Last Name:RUPP
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 MAIN ST
Mailing Address - Street 2:PO BOX 188
Mailing Address - City:SANBORN
Mailing Address - State:IA
Mailing Address - Zip Code:51248-7727
Mailing Address - Country:US
Mailing Address - Phone:712-930-3949
Mailing Address - Fax:
Practice Address - Street 1:109 MAIN ST
Practice Address - Street 2:
Practice Address - City:SANBORN
Practice Address - State:IA
Practice Address - Zip Code:51248-7727
Practice Address - Country:US
Practice Address - Phone:712-930-3949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-03
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007176111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor