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Individual

MELANIE GONZALEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
2406 E R.D. MIZE RD STE. B, INDEPENDENCE, MO 64057-6405
(816) 478-3338
Mailing address
2406 E R D MIZE R.D. STE B, INDEPENDENCE, MO 64057
(816) 478-3338

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
2018032267
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1992185763
MO
Enumeration date
06/05/2015
Last updated
10/21/2019
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