Provider Demographics
NPI:1851462592
Name:JAFARI, MELODY M (DC)
Entity type:Individual
Prefix:DR
First Name:MELODY
Middle Name:M
Last Name:JAFARI
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 1:2814 N 36TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-1303
Mailing Address - Country:US
Mailing Address - Phone:602-956-5561
Mailing Address - Fax:602-956-5561
Practice Address - Street 1:2814 N 36TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-1303
Practice Address - Country:US
Practice Address - Phone:602-956-5561
Practice Address - Fax:602-956-5561
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6053111N00000X
AZ453171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z63048Medicare ID - Type Unspecified
U82136Medicare UPIN