Provider Demographics
NPI:1174546477
Name:MELLING, HEATHER JUSTINE (DC)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:JUSTINE
Last Name:MELLING
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 1:275 N HIGHWAY 16
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-3000
Mailing Address - Country:US
Mailing Address - Phone:704-489-1999
Mailing Address - Fax:
Practice Address - Street 1:275 N HIGHWAY 16
Practice Address - Street 2:SUITE 102
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-3000
Practice Address - Country:US
Practice Address - Phone:704-489-1999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2447111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0829LOtherBCBS
NC5251639OtherAETNA
NC890829LMedicaid
NC0829LOtherBCBS
NCU61368Medicare UPIN