Provider Demographics
NPI:1548757511
Name:MURDOCK FAMILY WELLNESS, INC
Entity Type:Organization
Organization Name:MURDOCK FAMILY WELLNESS, INC
Other - Org Name:MURDOCK FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:MURDOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:435-213-9582
Mailing Address - Street 1:555 W 100 N STE C
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:UT
Mailing Address - Zip Code:84332-9863
Mailing Address - Country:US
Mailing Address - Phone:435-213-9582
Mailing Address - Fax:
Practice Address - Street 1:555 W 100 N STE C
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:UT
Practice Address - Zip Code:84332-9863
Practice Address - Country:US
Practice Address - Phone:435-213-9582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9777743-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty