=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841418993
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MUSSER CHIROPRACTIC, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/23/2007
-----------------------------------------------------
Last Update Date | 07/16/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 34734 VINE ST
-----------------------------------------------------
City | WILLOWICK
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44095-5120
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-975-2225
-----------------------------------------------------
Fax | 440-942-9050
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 34734 VINE ST
-----------------------------------------------------
City | WILLOWICK
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44095-5120
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-975-2225
-----------------------------------------------------
Fax | 440-942-9050
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT OWNER
-----------------------------------------------------
Name | DR. WILLIAM C. MUSSER
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 440-975-2225
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111NR0400X
-----------------------------------------------------
Taxonomy Name | Rehabilitation Chiropractor
-----------------------------------------------------
License Number | 1924
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------