Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 2102 | MA |
Y | 111NN1001X | Nutrition | 6195 | MO |
NPI | 1083758619 |
---|---|
Provider Name | Dr. Melissa Joan Cristiani |
First Address | Maryland Heights, MO 63043-2418 |
Second Address | Maryland Heights, MO 63043-2418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2007 |
Last Update Date | 14/10/2008 |