Provider Demographics
NPI:1598823908
Name:MULLENMEISTER, MELANIE P (DC)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:P
Last Name:MULLENMEISTER
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 1:1415 WEST HAVENS STREET
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MITCHELL
Mailing Address - State:SD
Mailing Address - Zip Code:57301-4116
Mailing Address - Country:US
Mailing Address - Phone:605-996-1160
Mailing Address - Fax:605-996-6433
Practice Address - Street 1:1415 WEST HAVENS STREET
Practice Address - Street 2:SUITE 3
Practice Address - City:MITCHELL
Practice Address - State:SD
Practice Address - Zip Code:57301-4116
Practice Address - Country:US
Practice Address - Phone:605-996-1160
Practice Address - Fax:605-996-6433
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1039111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor