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General NPI Number Information
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NPI Number | 1962869685
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Entity Type | Individual
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Provider Name | EDWARD MUSSI JR.
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Gender | Male
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Dates
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Enumeration Date | 01/26/2016
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Last Update Date | 01/26/2016
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Provider Practice Location Address
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Address Line | 1051 4TH AVE,
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City | GALLIPOLIS
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State | OH
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Zip | 45631
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Country | US
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Telephone | 740-446-5534
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Fax |
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Provider Business Mailing Address
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Address Line | 9145 YORKSHIRE DR
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City | SALINE
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State | MI
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Zip | 48176-9444
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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