Provider Demographics
NPI:1508878232
Name:MUSICK, CARL TIMOTHY (DC)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:TIMOTHY
Last Name:MUSICK
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 1:103 CHARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-2476
Mailing Address - Country:US
Mailing Address - Phone:276-628-8167
Mailing Address - Fax:276-628-8914
Practice Address - Street 1:103 CHARWOOD DR
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-2476
Practice Address - Country:US
Practice Address - Phone:276-628-8167
Practice Address - Fax:276-628-8914
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000264111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAT87210Medicare UPIN