MEDICARE: MUSE FAMILY CHIROPRACTIC LLC

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	2765	TN

General Provider Information

NPI Number	:	1992118814
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MUSE FAMILY CHIROPRACTIC LLC

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	:	423-247-2473

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	:	423-247-2473

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	DR. JOSEPH ALLAN MUSE
Credential	:	D.C.
Telephone Number	:	423-367-3050

Provider Enumeration Date	:	06/09/2014
Last Update Date	:	06/09/2014

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