Provider Demographics
NPI:1487840088
Name:MURRAY, EILEEN P (LIC AC)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:P
Last Name:MURRAY
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 56
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04841-0056
Mailing Address - Country:US
Mailing Address - Phone:207-576-5360
Mailing Address - Fax:
Practice Address - Street 1:75 MECHANIC ST
Practice Address - Street 2:SUITE103W
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-3513
Practice Address - Country:US
Practice Address - Phone:207-576-5360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA327171100000X
MEAC347171100000X
NH021171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist