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General NPI Number Information
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NPI Number | 1881885754
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Entity Type | Organization
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Legal Business Name | MUSICK CHIROPRACTIC CENTER PLC
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Dates
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Enumeration Date | 08/06/2007
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Last Update Date | 06/18/2015
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Provider Practice Location Address
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Address Line | 103 CHARWOOD DR
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City | ABINGDON
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State | VA
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Zip | 24210-2476
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Country | US
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Telephone | 276-628-8167
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Fax | 276-628-8914
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Provider Business Mailing Address
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Address Line | 103 CHARWOOD DR
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City | ABINGDON
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State | VA
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Zip | 24210-2476
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Country | US
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Telephone | 276-628-8167
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Fax | 276-628-8914
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Authorized Official
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Title or Position | OWNER
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Name | DR. CARL TIMOTHY MUSICK
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Credential | D.C.
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Telephone | 276-628-8167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0104000264
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License Number State | VA
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