Provider Demographics
NPI:1891994422
Name:MULLEN CHIROPRACTIC NEUROLOGY
Entity Type:Organization
Organization Name:MULLEN CHIROPRACTIC NEUROLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:V
Authorized Official - Last Name:MULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-953-1930
Mailing Address - Street 1:1200 BUSTLETON PIKE STE 16A
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-4109
Mailing Address - Country:US
Mailing Address - Phone:215-953-1930
Mailing Address - Fax:
Practice Address - Street 1:1200 BUSTLETON PIKE STE 16A
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-4109
Practice Address - Country:US
Practice Address - Phone:215-953-1930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003531-L111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT29838Medicare UPIN
PA164988Medicare PIN