Provider Demographics
NPI:1003058710
Name:JPM CHIROPRACTIC LLC
Entity type:Organization
Organization Name:JPM CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:608-767-2226
Mailing Address - Street 1:PO BOX 364
Mailing Address - Street 2:
Mailing Address - City:BLACK EARTH
Mailing Address - State:WI
Mailing Address - Zip Code:53515-0364
Mailing Address - Country:US
Mailing Address - Phone:608-767-2226
Mailing Address - Fax:608-767-3226
Practice Address - Street 1:9749 KAHL RD
Practice Address - Street 2:
Practice Address - City:BLACK EARTH
Practice Address - State:WI
Practice Address - Zip Code:53515-9516
Practice Address - Country:US
Practice Address - Phone:608-767-2226
Practice Address - Fax:608-767-3226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-26
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2509111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38938200Medicaid
WI1164597209OtherNPI
WI000035413Medicare PIN