Provider Demographics
NPI:1831231471
Name:BOSCH, MELISSA ANN (DC)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:ANN
Last Name:BOSCH
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 1:2407 COUNTY RD 1430
Mailing Address - Street 2:
Mailing Address - City:CAIRO
Mailing Address - State:MO
Mailing Address - Zip Code:65239
Mailing Address - Country:US
Mailing Address - Phone:660-269-8328
Mailing Address - Fax:
Practice Address - Street 1:105 S BROADWAY
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MO
Practice Address - Zip Code:65281
Practice Address - Country:US
Practice Address - Phone:660-388-5819
Practice Address - Fax:660-388-6930
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006390111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor