Provider Demographics
NPI:1497885503
Name:SIX, MELANIE LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:LYNN
Last Name:SIX
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 1:2121 EISENHOWER AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-5304
Mailing Address - Country:US
Mailing Address - Phone:703-370-1800
Mailing Address - Fax:703-370-6118
Practice Address - Street 1:2121 EISENHOWER AVE STE 101
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-5304
Practice Address - Country:US
Practice Address - Phone:703-370-1800
Practice Address - Fax:703-370-6118
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555987111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC491730Medicare PIN