Provider Demographics
NPI:1215036306
Name:MUROLO, CHRISTOPHER LAWRENCE (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:LAWRENCE
Last Name:MUROLO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:DILLON
Other - Middle Name:CHRIO
Other - Last Name:CLINIC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:221 S IDAHO ST
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:MT
Mailing Address - Zip Code:59725-2529
Mailing Address - Country:US
Mailing Address - Phone:406-683-6850
Mailing Address - Fax:406-683-6850
Practice Address - Street 1:221 S IDAHO ST
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:MT
Practice Address - Zip Code:59725-2529
Practice Address - Country:US
Practice Address - Phone:406-683-6850
Practice Address - Fax:406-683-6850
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT948111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000040003OtherBLUE CROSS BLUE SHIELD
MT0162741Medicaid
MT0162758Medicaid
MT0162741Medicaid