Provider Demographics
NPI:1508914920
Name:NEELEY, MELANIE (DC)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:NEELEY
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 1:12000 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-3730
Mailing Address - Country:US
Mailing Address - Phone:530-888-8771
Mailing Address - Fax:530-888-8772
Practice Address - Street 1:12000 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-3730
Practice Address - Country:US
Practice Address - Phone:530-888-8771
Practice Address - Fax:530-888-8772
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC11722111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5462626OtherFIRST HEALTH
CADC11722OtherLICENSE
CADC0117220Medicare ID - Type Unspecified
CA5462626OtherFIRST HEALTH