MEDICARE: MULLER CHIROPRACTIC, INC.

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	0104000474	VA

General Provider Information

NPI Number	:	1700026473
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MULLER CHIROPRACTIC, INC.

Provider Business Mailing Address
First Line	:	14107 BEACHMERE DR
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23831-6570
Country	:	US
Telephone Number	:	804-748-9068
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 ESSEX RD
Second Line	:
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-2442
Country	:	US
Telephone Number	:	804-520-7246
Fax Number	:

Authorized Official
Title or Position	:	PRES.
Name	:	DR. GLENN S. MULLER
Credential	:	D.C.
Telephone Number	:	804-520-7246

Provider Enumeration Date	:	02/20/2009
Last Update Date	:	02/20/2009

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