Provider Demographics
NPI:1790860989
Name:MUSSER CH, JOHN
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:MUSSER CH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9879 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-0000
Mailing Address - Country:US
Mailing Address - Phone:513-936-8200
Mailing Address - Fax:513-936-8212
Practice Address - Street 1:9879 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-0000
Practice Address - Country:US
Practice Address - Phone:513-936-8200
Practice Address - Fax:513-936-8212
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3138111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2245645Medicaid
OH2245645Medicaid
OH4051612Medicare PIN