Provider Demographics
NPI:1326172487
Name:PERLEE, MELINDA (DC)
Entity Type:Individual
Prefix:MS
First Name:MELINDA
Middle Name:
Last Name:PERLEE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:
Other - Last Name:PERLEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:1208 VIRGINIA ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94702-1338
Mailing Address - Country:US
Mailing Address - Phone:510-287-9279
Mailing Address - Fax:510-527-4958
Practice Address - Street 1:1208 VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94702-1338
Practice Address - Country:US
Practice Address - Phone:510-287-9279
Practice Address - Fax:510-527-4958
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1326111N00000X
AZ5511111N00000X
AZ3169225100000X
CA23088111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC 23088OtherSTATE
AZ5511OtherAZ DC LICENSE
NM1326OtherNM DC LICENSE
NM1326OtherNM DC LICENSE