Provider Demographics
NPI:1528587524
Name:WESSEL, MELISSA (DC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:WESSEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:428 CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417-1426
Mailing Address - Country:US
Mailing Address - Phone:704-651-9309
Mailing Address - Fax:
Practice Address - Street 1:700 WASHINGTON AVE STE 260
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-1462
Practice Address - Country:US
Practice Address - Phone:231-440-9338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010594111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor