Provider Demographics
NPI:1780808428
Name:MEUSSLING, JEREMIAH T (DC)
Entity type:Individual
Prefix:DR
First Name:JEREMIAH
Middle Name:T
Last Name:MEUSSLING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1234 RIDGEWOOD DR
Mailing Address - Street 2:STE A
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 1:1616 E WOOSTER ST
Practice Address - Street 2:SUITE 21
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-3478
Practice Address - Country:US
Practice Address - Phone:419-353-1212
Practice Address - Fax:419-353-3440
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3445111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4128551Medicare PIN