Individual
DR. KEVIN LYLE MELICHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3902 13TH AVE SW, FARGO, ND 58103-3357
(701) 282-5880
Mailing address
3902 13TH AVE SW, FARGO, ND 58103-3357
(701) 235-3835
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ND360
ND
Other
Enumeration date
06/27/2006
Last updated
06/30/2010
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