Provider Demographics
NPI:1679228555
Name:DAVIES, MELISSA (OD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:DAVIES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10166 KNOLL CIR
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130-8016
Mailing Address - Country:US
Mailing Address - Phone:303-981-0957
Mailing Address - Fax:
Practice Address - Street 1:16205 W 64TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80007-7401
Practice Address - Country:US
Practice Address - Phone:303-424-2991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-18
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT.0003927152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist