Provider Demographics
NPI:1508925512
Name:MELCHER, ALESA JO (DC)
Entity Type:Individual
Prefix:DR
First Name:ALESA
Middle Name:JO
Last Name:MELCHER
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 1:407 S 17TH ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-4724
Mailing Address - Country:US
Mailing Address - Phone:402-379-4870
Mailing Address - Fax:402-379-0204
Practice Address - Street 1:407 S 17TH ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-4724
Practice Address - Country:US
Practice Address - Phone:402-379-4870
Practice Address - Fax:402-379-0204
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1056111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE09815OtherBLUE CROSS BLUE SHIELD #
NE47079705600Medicaid
NE47079705600Medicaid
NEU40485Medicare UPIN
NE099679Medicare ID - Type UnspecifiedMEDICARE GROUP #