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General NPI Number Information
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NPI Number | 1003058710
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Entity Type | Organization
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Legal Business Name | JPM CHIROPRACTIC LLC
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Dates
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Enumeration Date | 03/26/2009
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Last Update Date | 03/26/2009
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Provider Practice Location Address
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Address Line | 9749 KAHL RD
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City | BLACK EARTH
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State | WI
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Zip | 53515-9516
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Country | US
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Telephone | 608-767-2226
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Fax | 608-767-3226
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Provider Business Mailing Address
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Address Line | PO BOX 364
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City | BLACK EARTH
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State | WI
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Zip | 53515-0364
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Country | US
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Telephone | 608-767-2226
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Fax | 608-767-3226
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Authorized Official
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Title or Position | CHIROPRACTOR OWNER
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Name | DR. JOHN P MURPHY
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Credential | DC
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Telephone | 608-767-2226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2509
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License Number State | WI
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