Provider Demographics
NPI:1760422851
Name:MUSE, RONALD D (DC)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:D
Last Name:MUSE
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 1:130 STONEBRIDGE BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-2056
Mailing Address - Country:US
Mailing Address - Phone:731-984-9800
Mailing Address - Fax:731-984-7346
Practice Address - Street 1:130 STONEBRIDGE BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-2056
Practice Address - Country:US
Practice Address - Phone:731-984-9800
Practice Address - Fax:731-984-7346
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05034111N00000X
OK3499111N00000X
TN2135111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor