MEDICARE: JOSEPH ALLAN MUSE D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC0000002765	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	103G703094	OTHER	TN	MEDICARE PTAN

General Provider Information

NPI Number	:	1639486574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH ALLAN MUSE D.C.

Provider Business Mailing Address
First Line	:	1732 N EASTMAN RD
Second Line	:	SUITE 3A
City	:	KINGSPORT
State	:	TN
Zip	:	37664-2376
Country	:	US
Telephone Number	:	423-247-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1732 N EASTMAN RD
Second Line	:	SUITE 3A
City	:	KINGSPORT
State	:	TN
Zip	:	37664-2376
Country	:	US
Telephone Number	:	423-247-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2010
Last Update Date	:	11/22/2016

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