Provider Demographics
NPI:1114310638
Name:WINTERSCHEIDT, MELISSA (DC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:WINTERSCHEIDT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:CUTBURTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:10001 W 63RD ST S
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:KS
Mailing Address - Zip Code:67026-8940
Mailing Address - Country:US
Mailing Address - Phone:316-239-5869
Mailing Address - Fax:
Practice Address - Street 1:101 N RIDGE RD STE 5
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-3367
Practice Address - Country:US
Practice Address - Phone:316-744-2001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-08
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05633111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSKA1794005Medicare PIN