Provider Demographics
NPI:1417058124
Name:MURRAY GENTLE CHIROPRACTIC INC
Entity Type:Organization
Organization Name:MURRAY GENTLE CHIROPRACTIC INC
Other - Org Name:LYNDON CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:E
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:785-828-3322
Mailing Address - Street 1:603 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:LYNDON
Mailing Address - State:KS
Mailing Address - Zip Code:66451-9858
Mailing Address - Country:US
Mailing Address - Phone:785-828-3322
Mailing Address - Fax:785-828-4807
Practice Address - Street 1:603 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:LYNDON
Practice Address - State:KS
Practice Address - Zip Code:66451-9858
Practice Address - Country:US
Practice Address - Phone:785-828-3322
Practice Address - Fax:785-828-4807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-03582111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS660024OtherLEGACY
KS1B060921OtherBLUE SHIELD