Provider Demographics
NPI:1952469827
Name:MURPHY EDEL, MARILYN ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:ANN
Last Name:MURPHY EDEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:MARILYN
Other - Middle Name:ANN
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22811 GREATER MACK
Mailing Address - Street 2:SUITE L 9 2
Mailing Address - City:ST CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-2052
Mailing Address - Country:US
Mailing Address - Phone:586-778-7610
Mailing Address - Fax:
Practice Address - Street 1:22811 GREATER MACK
Practice Address - Street 2:SUITE L 9 2
Practice Address - City:ST CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-2052
Practice Address - Country:US
Practice Address - Phone:586-778-7610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI004053111N00000X
GA1266111N00000X
NYX009122111N00000X
SC2588111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor