Provider Demographics
NPI:1013101542
Name:HUSSER, NICHOLAS ADAM (DC)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:ADAM
Last Name:HUSSER
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 1:3635 EDGEBROOKE DR
Mailing Address - Street 2:APT 309
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-5696
Mailing Address - Country:US
Mailing Address - Phone:330-461-1121
Mailing Address - Fax:
Practice Address - Street 1:4036 CENTER RD
Practice Address - Street 2:SUITE A
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-5696
Practice Address - Country:US
Practice Address - Phone:330-460-5151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3834111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor