Provider Demographics
NPI:1821221292
Name:MURPHY CHIROPRACTIC CENTER-MEXICO PC
Entity Type:Organization
Organization Name:MURPHY CHIROPRACTIC CENTER-MEXICO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:573-221-1075
Mailing Address - Street 1:400 MARK TWAIN AVE
Mailing Address - Street 2:
Mailing Address - City:HANNIBAL
Mailing Address - State:MO
Mailing Address - Zip Code:63401-3249
Mailing Address - Country:US
Mailing Address - Phone:573-221-1075
Mailing Address - Fax:573-221-1433
Practice Address - Street 1:3618 S CLARK ST
Practice Address - Street 2:
Practice Address - City:MEXICO
Practice Address - State:MO
Practice Address - Zip Code:65265-4104
Practice Address - Country:US
Practice Address - Phone:573-581-2446
Practice Address - Fax:573-581-2448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-01
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCE003638111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOMA2199Medicare PIN