Provider Demographics
NPI:1396841573
Name:MURRAY, ANTHONY PAUL (DC DACO CCSP)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:PAUL
Last Name:MURRAY
Suffix:
Gender:M
Credentials:DC DACO CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 22ND AVE S
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-2822
Mailing Address - Country:US
Mailing Address - Phone:605-697-5090
Mailing Address - Fax:605-697-5090
Practice Address - Street 1:750 22ND AVE S
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-2822
Practice Address - Country:US
Practice Address - Phone:605-697-5090
Practice Address - Fax:605-697-5090
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD708111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0080133OtherBCBS SD
SD80133Medicare PIN