Provider Demographics
NPI:1134139959
Name:OSBORN, MELISSA BORNEMANN (DC)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:BORNEMANN
Last Name:OSBORN
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 1:7487 GRAND RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-9374
Mailing Address - Country:US
Mailing Address - Phone:810-588-6314
Mailing Address - Fax:810-433-5979
Practice Address - Street 1:7487 GRAND RIVER RD
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-9374
Practice Address - Country:US
Practice Address - Phone:810-588-6314
Practice Address - Fax:810-433-5979
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009515111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor