Healthcare Provider Details

I. General information

NPI: 1245432681
Provider Name (Legal Business Name): TERRENCE MURPHY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 25TH AVENUE SOUTH SUITE 102
ST. CLOUD MN
56301
US

IV. Provider business mailing address

606 25TH AVENUE SOUTH SUITE 102
ST. CLOUD MN
56301
US

V. Phone/Fax

Practice location:
  • Phone: 320-251-4848
  • Fax: 320-251-4661
Mailing address:
  • Phone: 320-251-4848
  • Fax: 320-251-4661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3517
License Number StateMN

VIII. Authorized Official

Name: DR. TERRENCE J MURPHY
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: D.C.
Phone: 320-251-4848