Provider Demographics
NPI:1073244521
Name:MCMURRY, RYLIE ELIZABETH (LAT, ATC, CSCS)
Entity Type:Individual
Prefix:
First Name:RYLIE
Middle Name:ELIZABETH
Last Name:MCMURRY
Suffix:
Gender:F
Credentials:LAT, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4005 GOLETA PL
Mailing Address - Street 2:
Mailing Address - City:DISCOVERY BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94505-1117
Mailing Address - Country:US
Mailing Address - Phone:925-301-6244
Mailing Address - Fax:
Practice Address - Street 1:7425 OLD MAIN HL
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84322-9049
Practice Address - Country:US
Practice Address - Phone:435-797-3636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-23
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12907373-48102255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer