Provider Demographics
NPI:1760628952
Name:SHERA, MELISSA (DC)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:
Last Name:SHERA
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:W243N2344 SADDLE BROOK DR
Mailing Address - Street 2:#211
Mailing Address - City:PEWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53072-5896
Mailing Address - Country:US
Mailing Address - Phone:952-250-4543
Mailing Address - Fax:
Practice Address - Street 1:W243N2344 SADDLE BROOK DR
Practice Address - Street 2:#211
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53072-5896
Practice Address - Country:US
Practice Address - Phone:952-250-4543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-18
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4454012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor