Provider Demographics
NPI:1972871754
Name:THOMAS, MELONY KAY (DC)
Entity Type:Individual
Prefix:
First Name:MELONY
Middle Name:KAY
Last Name:THOMAS
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 1:145 CYPRESS POINT PKWY STE 208
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-8427
Mailing Address - Country:US
Mailing Address - Phone:386-445-4455
Mailing Address - Fax:
Practice Address - Street 1:145 CYPRESS POINT PKWY STE 208
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-8427
Practice Address - Country:US
Practice Address - Phone:386-445-4455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-07
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10498111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor