Provider Demographics
NPI:1497111256
Name:MUSE, BRAD (DC, AT, CSCS)
Entity Type:Individual
Prefix:
First Name:BRAD
Middle Name:
Last Name:MUSE
Suffix:
Gender:M
Credentials:DC, AT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6077 FRANTZ RD STE 103
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-3373
Mailing Address - Country:US
Mailing Address - Phone:614-389-4473
Mailing Address - Fax:
Practice Address - Street 1:6077 FRANTZ RD STE 103
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-3373
Practice Address - Country:US
Practice Address - Phone:740-815-7177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-11
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT.0036822255A2300X
OHDC-05092111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer