Provider Demographics
NPI:1710199922
Name:SAUVAGE, MELINDA ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:ANN
Last Name:SAUVAGE
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 1:780 CLIFFORD DR
Mailing Address - Street 2:
Mailing Address - City:EMMETT
Mailing Address - State:ID
Mailing Address - Zip Code:83617-9035
Mailing Address - Country:US
Mailing Address - Phone:509-994-3969
Mailing Address - Fax:
Practice Address - Street 1:780 CLIFFORD DR
Practice Address - Street 2:
Practice Address - City:EMMETT
Practice Address - State:ID
Practice Address - Zip Code:83617-9035
Practice Address - Country:US
Practice Address - Phone:509-994-3969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30557111N00000X
IDDCA-2277111N00000X
VI096C111N00000X
WACH 60126765111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor