Provider Demographics
NPI:1538359476
Name:MUELLERLEILE, HERMINE (DC)
Entity type:Individual
Prefix:
First Name:HERMINE
Middle Name:
Last Name:MUELLERLEILE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15029 N THOMPSON PEAK PKWY
Mailing Address - Street 2:SUITE B111-425
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2217
Mailing Address - Country:US
Mailing Address - Phone:480-970-9525
Mailing Address - Fax:
Practice Address - Street 1:16597 N 92ND ST
Practice Address - Street 2:SUITE A108
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1779
Practice Address - Country:US
Practice Address - Phone:480-970-9525
Practice Address - Fax:480-596-0261
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4418111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor