Provider Demographics
NPI:1477734333
Name:MEUSSLING CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:MEUSSLING CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMIAH
Authorized Official - Middle Name:TAMBONE
Authorized Official - Last Name:MEUSSLING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:419-353-1212
Mailing Address - Street 1:1234 RIDGEWOOD DR STE A
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-2612
Mailing Address - Country:US
Mailing Address - Phone:419-353-1212
Mailing Address - Fax:419-353-3440
Practice Address - Street 1:1234 RIDGEWOOD DR STE A
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-2612
Practice Address - Country:US
Practice Address - Phone:419-353-1212
Practice Address - Fax:419-353-3440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3445111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9342831Medicare PIN