Healthcare Provider Details

I. General information

NPI: 1497111256
Provider Name (Legal Business Name): BRAD MUSE DC, AT, CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2016
Last Update Date: 05/04/2021
Certification Date: 05/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6077 FRANTZ RD STE 103
DUBLIN OH
43017-3373
US

IV. Provider business mailing address

6077 FRANTZ RD STE 103
DUBLIN OH
43017-3373
US

V. Phone/Fax

Practice location:
  • Phone: 740-815-7177
  • Fax:
Mailing address:
  • Phone: 614-389-4473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-05092
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT.003682
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: