Provider Demographics
NPI:1083758619
Name:CRISTIANI, MELISSA JOAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:JOAN
Last Name:CRISTIANI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12131 DORSETT RD
Mailing Address - Street 2:209
Mailing Address - City:MARYLAND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043-2418
Mailing Address - Country:US
Mailing Address - Phone:314-291-3666
Mailing Address - Fax:314-291-3668
Practice Address - Street 1:12131 DORSETT RD
Practice Address - Street 2:209
Practice Address - City:MARYLAND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63043-2418
Practice Address - Country:US
Practice Address - Phone:314-291-3666
Practice Address - Fax:314-291-3668
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO6195111NN1001X
MA2102111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
No111N00000XChiropractic ProvidersChiropractor