Provider Demographics
NPI:1487997631
Name:MURRAY, TARA MICHELLE (DC)
Entity type:Individual
Prefix:DR
First Name:TARA
Middle Name:MICHELLE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8980 S US HIGHWAY 1 STE 104
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-3482
Mailing Address - Country:US
Mailing Address - Phone:772-336-8600
Mailing Address - Fax:772-464-9978
Practice Address - Street 1:8980 S US HIGHWAY 1 STE 104
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-3482
Practice Address - Country:US
Practice Address - Phone:772-336-8600
Practice Address - Fax:772-464-9978
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-05
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10870111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor