Provider Demographics
NPI:1679766703
Name:IN-LINE CHIROPRACTIC INC
Entity type:Organization
Organization Name:IN-LINE CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR./CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MURACK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-278-3602
Mailing Address - Street 1:320 1ST AVE SW
Mailing Address - Street 2:
Mailing Address - City:CONRAD
Mailing Address - State:MT
Mailing Address - Zip Code:59425-1836
Mailing Address - Country:US
Mailing Address - Phone:406-248-3602
Mailing Address - Fax:406-278-3207
Practice Address - Street 1:320 1ST AVE SW
Practice Address - Street 2:
Practice Address - City:CONRAD
Practice Address - State:MT
Practice Address - Zip Code:59425-1836
Practice Address - Country:US
Practice Address - Phone:406-278-3602
Practice Address - Fax:406-278-3207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000080017Medicare PIN