Provider Demographics
NPI:1023111077
Name:MARR, MELISSA A (DC)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:A
Last Name:MARR
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 1:379 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-4037
Mailing Address - Country:US
Mailing Address - Phone:978-373-7871
Mailing Address - Fax:978-374-3005
Practice Address - Street 1:379 MAIN ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-4037
Practice Address - Country:US
Practice Address - Phone:978-373-7871
Practice Address - Fax:978-374-3005
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3082111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAS400147889Medicare PIN