Provider Demographics
NPI:1306187208
Name:MELESKI FAMILY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:MELESKI FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MELESKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-247-5889
Mailing Address - Street 1:2140 W KENDALL AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-4317
Mailing Address - Country:US
Mailing Address - Phone:262-247-5889
Mailing Address - Fax:
Practice Address - Street 1:N89W16800 APPLETON AVE
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-2039
Practice Address - Country:US
Practice Address - Phone:262-247-5889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-04
Last Update Date:2013-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty