Provider Demographics
NPI:1477185999
Name:MELTINORD, DEAN ACHESON R (DC)
Entity Type:Individual
Prefix:DR
First Name:DEAN ACHESON
Middle Name:R
Last Name:MELTINORD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 BRYN MAWR AVE APT 214
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-2104
Mailing Address - Country:US
Mailing Address - Phone:404-618-7766
Mailing Address - Fax:
Practice Address - Street 1:213 W 4TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-2204
Practice Address - Country:US
Practice Address - Phone:404-618-7766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0001009111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor