Provider Demographics
NPI:1538202205
Name:MCMURTRY, SHANNON ONEAL (DC)
Entity type:Individual
Prefix:MR
First Name:SHANNON
Middle Name:ONEAL
Last Name:MCMURTRY
Suffix:
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 1:206 WALTON RD
Mailing Address - Street 2:
Mailing Address - City:HAMPSHIRE
Mailing Address - State:TN
Mailing Address - Zip Code:38461-5132
Mailing Address - Country:US
Mailing Address - Phone:931-379-9926
Mailing Address - Fax:
Practice Address - Street 1:622 W 7TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-3139
Practice Address - Country:US
Practice Address - Phone:931-380-1144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0492111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor