Provider Demographics
NPI:1659589778
Name:PLACE, MELISSA KATHLEEN (DC)
Entity Type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:KATHLEEN
Last Name:PLACE
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 1:196 MEADOR WAY SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315-6621
Mailing Address - Country:US
Mailing Address - Phone:678-793-9260
Mailing Address - Fax:
Practice Address - Street 1:3001 N DRUID HILLS RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-3911
Practice Address - Country:US
Practice Address - Phone:404-248-1771
Practice Address - Fax:404-248-1764
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008048111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor