Provider Demographics
NPI:1366869604
Name:MURPHY, RAYMOND LOCKWOOD JR (PT, DPT, CSCS)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:LOCKWOOD
Last Name:MURPHY
Suffix:JR
Gender:M
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 1/2 TRADD ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-2420
Mailing Address - Country:US
Mailing Address - Phone:843-670-0871
Mailing Address - Fax:
Practice Address - Street 1:128 1/2 TRADD ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-2420
Practice Address - Country:US
Practice Address - Phone:843-670-0871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6830225100000X
GAPT010803225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist