Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 7684 | AZ |
N | 111NR0400X | Rehabilitation Chiropractor | 4368 | AZ |
NPI | 1356551402 |
---|---|
Provider Name | Dr. Melissa Rose Filippello |
First Address | Queen Creek, AZ 85142-1809 |
Second Address | Gilbert, AZ 85297 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 25/08/2018 |