Provider Demographics
NPI:1073550018
Name:MURPHY, KATIE MAE (DC)
Entity Type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:MAE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:MAE
Other - Last Name:KNECHTLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10834 VINCENT AVE S
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431
Mailing Address - Country:US
Mailing Address - Phone:952-253-1381
Mailing Address - Fax:
Practice Address - Street 1:470 W 78TH ST
Practice Address - Street 2:STE 120
Practice Address - City:CHANHASSEN
Practice Address - State:MN
Practice Address - Zip Code:55317
Practice Address - Country:US
Practice Address - Phone:952-949-0676
Practice Address - Fax:952-949-0868
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4727111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor