Provider Demographics
NPI:1093822348
Name:MURPHY, RICHARD TODD (DC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:TODD
Last Name:MURPHY
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 1:812 S GARFIELD AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-3456
Mailing Address - Country:US
Mailing Address - Phone:231-946-3780
Mailing Address - Fax:
Practice Address - Street 1:812 S GARFIELD AVE STE 6
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-3456
Practice Address - Country:US
Practice Address - Phone:231-946-3780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008081111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4792312Medicaid
MI950B811450OtherBLUE CROSS BLUE SHIELD