Provider Demographics
NPI:1114995248
Name:MURPHY, MAURA A (PT)
Entity Type:Individual
Prefix:
First Name:MAURA
Middle Name:A
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 AUDUBON DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-2613
Mailing Address - Country:US
Mailing Address - Phone:404-966-9658
Mailing Address - Fax:
Practice Address - Street 1:6610 BAY CIR
Practice Address - Street 2:#C
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-1267
Practice Address - Country:US
Practice Address - Phone:770-454-0900
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT005976225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist