Provider Demographics
NPI:1376699405
Name:GRIFFIN, MELANIE LYNNE (DC)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:LYNNE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:MELANIE
Other - Middle Name:LYNNE
Other - Last Name:GRIFFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5920 HWY 5 N STE 7
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022
Mailing Address - Country:US
Mailing Address - Phone:501-847-7026
Mailing Address - Fax:501-847-7016
Practice Address - Street 1:5920 HWY 5 N STE 7
Practice Address - Street 2:
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72022
Practice Address - Country:US
Practice Address - Phone:501-847-7026
Practice Address - Fax:501-847-7016
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1683111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5G335Medicare PIN
AR5A250Medicare PIN