MEDICARE: MELSON CHIROPRACTIC, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1234	OH

General Provider Information

NPI Number	:	1902060262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MELSON CHIROPRACTIC, INC.

Provider Business Mailing Address
First Line	:	4771 GLENDALE MILFORD RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45242-3819
Country	:	US
Telephone Number	:	513-793-4300
Fax Number	:	513-469-1880

Provider Business Practice Location Address
First Line	:	4771 GLENDALE MILFORD RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45242-3819
Country	:	US
Telephone Number	:	513-793-4300
Fax Number	:	513-469-1880

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TODD STEPHEN MELSON
Credential	:	D.C.
Telephone Number	:	513-793-4300

Provider Enumeration Date	:	07/16/2008
Last Update Date	:	07/16/2008

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