Healthcare Provider Details

I. General information

NPI: 1013965938
Provider Name (Legal Business Name): JENNIFER TRACHTE MURPHY DC, DICCP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 08/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 W BROADWAY ST
PINK HILL NC
28572-7986
US

IV. Provider business mailing address

312 W BROADWAY ST
PINK HILL NC
28572-7986
US

V. Phone/Fax

Practice location:
  • Phone: 252-568-6400
  • Fax: 252-568-6461
Mailing address:
  • Phone: 252-568-6400
  • Fax: 252-568-6461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2356
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: