Provider Demographics
NPI:1619978368
Name:KULLRICH, MURRAY PATRICK (DC)
Entity Type:Individual
Prefix:
First Name:MURRAY
Middle Name:PATRICK
Last Name:KULLRICH
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 1:1169 HILLTOP DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-3814
Mailing Address - Country:US
Mailing Address - Phone:530-223-1596
Mailing Address - Fax:530-223-0345
Practice Address - Street 1:1169 HILLTOP DR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-3814
Practice Address - Country:US
Practice Address - Phone:530-223-1596
Practice Address - Fax:530-223-0345
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15835111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T76492Medicare UPIN
CADC 0158350Medicare ID - Type Unspecified