Provider Demographics
NPI:1861548380
Name:MURPHY, MICHAEL LEE (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LEE
Last Name:MURPHY
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 1:9 MAPLE AVENUE EXT
Mailing Address - Street 2:
Mailing Address - City:UNCASVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06382-2417
Mailing Address - Country:US
Mailing Address - Phone:860-848-8977
Mailing Address - Fax:860-848-3572
Practice Address - Street 1:9 MAPLE AVENUE EXT
Practice Address - Street 2:
Practice Address - City:UNCASVILLE
Practice Address - State:CT
Practice Address - Zip Code:06382-2417
Practice Address - Country:US
Practice Address - Phone:860-848-8977
Practice Address - Fax:860-848-3572
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001446111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
45-2621908OtherTIN
45-2621908OtherTIN