Provider Demographics
NPI:1336540475
Name:CRUZ, MELANIE (DC)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:CRUZ
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 1:5713 BRIARWICK CT
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-4408
Mailing Address - Country:US
Mailing Address - Phone:615-779-6913
Mailing Address - Fax:
Practice Address - Street 1:5713 BRIARWICK CT
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-4408
Practice Address - Country:US
Practice Address - Phone:615-779-6913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2782111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor