Provider Demographics
NPI:1366618910
Name:GRAHAM-TIPLER, MELONY COLEEN (DC)
Entity type:Individual
Prefix:DR
First Name:MELONY
Middle Name:COLEEN
Last Name:GRAHAM-TIPLER
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 1:328 BLUE HILL AVE
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-1020
Mailing Address - Country:US
Mailing Address - Phone:617-250-8887
Mailing Address - Fax:617-273-2393
Practice Address - Street 1:328 BLUE HILL AVE
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-1020
Practice Address - Country:US
Practice Address - Phone:617-250-8887
Practice Address - Fax:617-273-2393
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3188111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist