Provider Demographics
NPI:1447336730
Name:MUSCHETT, NICOLE LEIGH (DC)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:LEIGH
Last Name:MUSCHETT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3005 BRODHEAD RD
Mailing Address - Street 2:SUITE 182
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020
Mailing Address - Country:US
Mailing Address - Phone:610-419-6550
Mailing Address - Fax:610-419-6554
Practice Address - Street 1:3005 BRODHEAD RD
Practice Address - Street 2:SUITE 182
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020
Practice Address - Country:US
Practice Address - Phone:610-419-6550
Practice Address - Fax:610-419-6554
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009293111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
143657Medicare UPIN
143657Medicare PIN