Provider Demographics
NPI:1558363010
Name:MURRAY, DANIEL T (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:T
Last Name:MURRAY
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 1:1452 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-1432
Mailing Address - Country:US
Mailing Address - Phone:262-646-5800
Mailing Address - Fax:262-646-5803
Practice Address - Street 1:1452 GENESEE ST
Practice Address - Street 2:
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-1432
Practice Address - Country:US
Practice Address - Phone:262-646-5800
Practice Address - Fax:262-646-5803
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2728-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIU20776Medicare UPIN
WI000068960-0001Medicare ID - Type UnspecifiedCLINIC-SEQUENCE NUMBER