Provider Demographics
NPI:1598830507
Name:PEROTTI, MELISSA A (DC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:PEROTTI
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:PO BOX 12956
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89510-2956
Mailing Address - Country:US
Mailing Address - Phone:775-689-9115
Mailing Address - Fax:775-827-6715
Practice Address - Street 1:9570 S MCCARRAN
Practice Address - Street 2:STE 110 ADVANCED HEALTH CHIROPRACTIC LLC
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523
Practice Address - Country:US
Practice Address - Phone:775-746-2555
Practice Address - Fax:775-746-2566
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01088111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1619029436Medicare PIN