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General NPI Number Information
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NPI Number | 1619028792
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Entity Type | Individual
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Provider Name | MELISSA ROSE BANYAI-DEL CARMEN D.C.
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Gender | Female
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Dates
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Enumeration Date | 01/15/2007
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Last Update Date | 04/25/2024
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Provider Practice Location Address
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Address Line | 281 CLARKSON RD SUITE 101
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City | ELLISVILLE
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State | MO
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Zip | 63011-2281
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Country | US
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Telephone | 636-207-9500
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Fax | 636-207-9555
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Provider Business Mailing Address
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Address Line | 281 CLARKSON RD STE 101
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City | ELLISVILLE
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State | MO
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Zip | 63011-2281
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Country | US
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Telephone | 636-675-8196
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2005014211
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License Number State | MO
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