Provider Demographics
NPI:1477677953
Name:MUSSER, ROBERT B (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:B
Last Name:MUSSER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5483 NW SAINT JAMES DRIVE
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983
Mailing Address - Country:US
Mailing Address - Phone:772-333-2057
Mailing Address - Fax:772-333-2130
Practice Address - Street 1:5483 NW SAINT JAMES DRIVE
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983
Practice Address - Country:US
Practice Address - Phone:772-333-2057
Practice Address - Fax:772-333-2130
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7798111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103252200Medicaid