Provider Demographics
NPI:1952354185
Name:MULLEN, JOSEPH V (DC, DIBCN)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:V
Last Name:MULLEN
Suffix:
Gender:M
Credentials:DC, DIBCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 BUSTLETON PIKE
Mailing Address - Street 2:STE16A
Mailing Address - City:FEASTERVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19053
Mailing Address - Country:US
Mailing Address - Phone:215-953-1930
Mailing Address - Fax:215-953-1930
Practice Address - Street 1:1200 BUSTLETON PIKE
Practice Address - Street 2:STE16A
Practice Address - City:FEASTERVILLE
Practice Address - State:PA
Practice Address - Zip Code:19053-4118
Practice Address - Country:US
Practice Address - Phone:215-953-1930
Practice Address - Fax:215-953-1930
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003531L111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMU164988Medicare ID - Type Unspecified