Provider Demographics
NPI:1235916024
Name:BATES, MELANY (DC)
Entity Type:Individual
Prefix:
First Name:MELANY
Middle Name:
Last Name:BATES
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 1:2875 E 850 N
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-5841
Mailing Address - Country:US
Mailing Address - Phone:325-642-7389
Mailing Address - Fax:406-812-5649
Practice Address - Street 1:2875 E 850 N
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-5841
Practice Address - Country:US
Practice Address - Phone:325-642-7389
Practice Address - Fax:406-812-5649
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12755304-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor