Provider Demographics
NPI:1619063864
Name:MURACK, RICHARD JOSEPH (DC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:JOSEPH
Last Name:MURACK
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 1:320 1ST AVE SW
Mailing Address - Street 2:
Mailing Address - City:CONRAD
Mailing Address - State:MT
Mailing Address - Zip Code:59425
Mailing Address - Country:US
Mailing Address - Phone:406-278-3602
Mailing Address - Fax:406-278-3207
Practice Address - Street 1:320 1ST AVE SW
Practice Address - Street 2:
Practice Address - City:CONRAD
Practice Address - State:MT
Practice Address - Zip Code:59425
Practice Address - Country:US
Practice Address - Phone:406-278-3602
Practice Address - Fax:406-278-3207
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT684111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor