Healthcare Provider Details

I. General information

NPI: 1356551402
Provider Name (Legal Business Name): MELISSA ROSE FILIPPELLO D.C., M.S., B.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 08/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8490 S POWER RD SUITE 105, PMB 103
GILBERT AZ
85297
US

IV. Provider business mailing address

PO BOX 484
QUEEN CREEK AZ
85142-1809
US

V. Phone/Fax

Practice location:
  • Phone: 480-292-2829
  • Fax:
Mailing address:
  • Phone: 480-292-2829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number7684
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number4368
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: