Provider Demographics
NPI:1831413038
Name:MELNAR, RANDALL KERWIN (DC)
Entity type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:KERWIN
Last Name:MELNAR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5781 BAYSHORE RD
Mailing Address - Street 2:# 103
Mailing Address - City:N FT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33917-3003
Mailing Address - Country:US
Mailing Address - Phone:239-567-0010
Mailing Address - Fax:
Practice Address - Street 1:5781 BAYSHORE RD
Practice Address - Street 2:# 103
Practice Address - City:N FT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33917-3003
Practice Address - Country:US
Practice Address - Phone:239-567-0010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9728111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic