Provider Information for 1831692037
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MELISSA ANN MELSON
Sex: Female
NPI: 1831692037
Last Updated: 2018-05-23
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1831692037 | ||||||||
| Enumeration Date | 2018-03-14 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 13101 ALLEN RD BLDG 4 SOUTHGATE, MI 48195-2216 United States Phone: 734-785-7700 | Fax: | ||||||||
| Primary Practice Address | 13101 ALLEN RD BLDG 4 SOUTHGATE, MI 48195 United States Phone: 734-785-7700 | Fax: | ||||||||
| Secondary Practice Address(es) | 2051 W. GRAND BLVD | ||||||||
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