Provider Demographics
NPI:1750315685
Name:MUSSMAN, JEFFERY LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:LYNN
Last Name:MUSSMAN
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 1:4633 N MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:WARR ACRES
Mailing Address - State:OK
Mailing Address - Zip Code:73122-5009
Mailing Address - Country:US
Mailing Address - Phone:405-848-3397
Mailing Address - Fax:405-603-3772
Practice Address - Street 1:4633 N MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:WARR ACRES
Practice Address - State:OK
Practice Address - Zip Code:73122-5009
Practice Address - Country:US
Practice Address - Phone:405-848-3397
Practice Address - Fax:405-603-3772
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3460111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor