Provider Demographics
NPI:1356846844
Name:YOUNG, MELISSA ANN (DC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:YOUNG
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 1:3100 INDEPENDENCE PKWY STE 311
Mailing Address - Street 2:#127
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-1997
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4708 W PLANO PKWY STE 300
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5336
Practice Address - Country:US
Practice Address - Phone:214-606-8611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13756111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor