Provider Demographics
NPI:1235140294
Name:MURRY, THERESA B (DC)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:B
Last Name:MURRY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 SMOKY BAY WAY # 148
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:AK
Mailing Address - Zip Code:99603-7653
Mailing Address - Country:US
Mailing Address - Phone:907-313-6300
Mailing Address - Fax:
Practice Address - Street 1:3780 BARTLETT ST
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:AK
Practice Address - Zip Code:99603-7503
Practice Address - Country:US
Practice Address - Phone:907-313-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK194946111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8866666Medicare PIN
WAG8866667Medicare PIN