Provider Demographics
NPI:1417302878
Name:HALLAM, MELINDA RATCLIFF (DC)
Entity Type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:RATCLIFF
Last Name:HALLAM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:K
Other - Last Name:RATCLIFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:826 MIDDLE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37862-5017
Mailing Address - Country:US
Mailing Address - Phone:865-453-1390
Mailing Address - Fax:
Practice Address - Street 1:826 MIDDLE CREEK RD
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-5017
Practice Address - Country:US
Practice Address - Phone:865-453-1390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2932111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor