Provider Demographics
NPI:1710239660
Name:MURCIA, DIEGO (DC)
Entity Type:Individual
Prefix:DR
First Name:DIEGO
Middle Name:
Last Name:MURCIA
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 1:365 WESTPORT AVE
Mailing Address - Street 2:STE 3
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-4345
Mailing Address - Country:US
Mailing Address - Phone:203-845-0400
Mailing Address - Fax:203-845-0005
Practice Address - Street 1:365 WESTPORT AVE
Practice Address - Street 2:STE 3
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-4345
Practice Address - Country:US
Practice Address - Phone:203-845-0400
Practice Address - Fax:203-845-0005
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001913111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor