Provider Demographics
NPI:1932295698
Name:BOSHELL, MURIS RAY JR (DC)
Entity Type:Individual
Prefix:DR
First Name:MURIS
Middle Name:RAY
Last Name:BOSHELL
Suffix:JR
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:P.O. BOX B
Mailing Address - Street 2:
Mailing Address - City:HALEYVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35565
Mailing Address - Country:US
Mailing Address - Phone:205-486-2000
Mailing Address - Fax:205-486-4406
Practice Address - Street 1:8177 HWY 13
Practice Address - Street 2:
Practice Address - City:HALEYVILLE
Practice Address - State:AL
Practice Address - Zip Code:35565
Practice Address - Country:US
Practice Address - Phone:205-486-2000
Practice Address - Fax:205-486-4406
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1461111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51001747OtherBCBS PROVIDER NUMBER
ALU35753Medicare UPIN
AL051556370Medicare ID - Type Unspecified