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General NPI Number Information
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NPI Number | 1932135894
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Entity Type | Individual
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Provider Name | GREGORY K MELLON D.C.,D.A.B.C.O.
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Gender | Male
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 10/03/2011
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Provider Practice Location Address
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Address Line | 1802 CASTLETON WAY
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City | DELAWARE
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State | OH
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Zip | 43015-1301
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Country | US
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Telephone | 740-363-3330
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Fax | 740-369-2124
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Provider Business Mailing Address
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Address Line | 1802 CASTLETON WAY
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City | DELAWARE
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State | OH
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Zip | 43015-1301
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Country | US
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Telephone | 740-363-3330
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Fax | 740-369-2124
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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 | 1000
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2933
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License Number State | MI
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