Provider Demographics
NPI:1588948897
Name:PAULA J MURPHY CHIROPRACTIC INC
Entity type:Organization
Organization Name:PAULA J MURPHY CHIROPRACTIC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:208-229-7242
Mailing Address - Street 1:12411 N HUMPHREYS WAY
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83714-9305
Mailing Address - Country:US
Mailing Address - Phone:208-229-7242
Mailing Address - Fax:
Practice Address - Street 1:12411 N HUMPHREYS WAY
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83714-9305
Practice Address - Country:US
Practice Address - Phone:208-229-7242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PAULA J MURPHY CHIROPRACTIC INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25257111N00000X
IDCHIA-1405111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0252570Medicare UPIN