Individual
DR. GARY DOUGLAS MELLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
5621 36TH AVE S, SUITE 200, FARGO, ND 58104-5269
(701) 429-7001
Mailing address
5621 36TH AVE S, SUITE 200, FARGO, ND 58104-5269
(701) 429-7001
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1039
ND
Other
Enumeration date
07/24/2012
Last updated
05/08/2017
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