Provider Demographics
NPI:1699274357
Name:MELENDEZ, LUCAS (DC)
Entity type:Individual
Prefix:DR
First Name:LUCAS
Middle Name:
Last Name:MELENDEZ
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 1:7215 S POWER RD STE B103
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-6336
Mailing Address - Country:US
Mailing Address - Phone:760-419-8981
Mailing Address - Fax:
Practice Address - Street 1:23149 S 230TH ST
Practice Address - Street 2:STE B103
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-1290
Practice Address - Country:US
Practice Address - Phone:760-489-0303
Practice Address - Fax:760-489-0480
Is Sole Proprietor?:No
Enumeration Date:2018-02-08
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34098111N00000X
AZ9016111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA34098OtherSTATE LICENSE