Provider Demographics
NPI:1558568956
Name:TIFFANY D MURRISH
Entity Type:Organization
Organization Name:TIFFANY D MURRISH
Other - Org Name:TIFFANY D. TAYLOR-MURRISH, D.C.
Other - Org Type:Other Name
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-752-0055
Mailing Address - Street 1:PO BOX 1415
Mailing Address - Street 2:
Mailing Address - City:LOVINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:88260-1415
Mailing Address - Country:US
Mailing Address - Phone:806-752-0055
Mailing Address - Fax:575-739-2225
Practice Address - Street 1:419 N AVENUE F
Practice Address - Street 2:
Practice Address - City:DENVER CITY
Practice Address - State:TX
Practice Address - Zip Code:79323-2741
Practice Address - Country:US
Practice Address - Phone:806-752-0055
Practice Address - Fax:575-739-2225
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BACK IN MOTION CHIROPRACTIC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-28
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9244111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1235168147OtherTYPE I NPI
TX15730101Medicaid
TX9244OtherTX LICENSE
TX609759Medicare ID - Type UnspecifiedMEDICARE NUMBER