Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 3444 | OH |
NPI | 1003812066 |
---|---|
Provider Name | Dr. Ted J Murdock |
First Address | Huber Heights, OH 45424-3200 |
Second Address | Huber Heights, OH 45424-3200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2005 |
Last Update Date | 08/07/2007 |