Provider Demographics
NPI:1902948490
Name:MUSACCHIO, CHRIS (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:
Last Name:MUSACCHIO
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 1:5500 HIGHWAY 49 S
Mailing Address - Street 2:SUITE 400
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075-8414
Mailing Address - Country:US
Mailing Address - Phone:704-455-1000
Mailing Address - Fax:704-455-1055
Practice Address - Street 1:5500 HWY 49 S
Practice Address - Street 2:SUITE 400
Practice Address - City:HARRISBURG
Practice Address - State:NC
Practice Address - Zip Code:28075-8414
Practice Address - Country:US
Practice Address - Phone:704-455-1000
Practice Address - Fax:704-455-1055
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC 2150111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0827ROtherBCBSNC PROVIDER NUMBER
NC890827RMedicaid
NC2449526Medicare ID - Type UnspecifiedPROVIDER NUMBER