Provider Demographics
NPI:1497797054
Name:MURRI, DAVID BRUCE (PT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:BRUCE
Last Name:MURRI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7550 W EMERALD ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-9015
Mailing Address - Country:US
Mailing Address - Phone:208-375-0666
Mailing Address - Fax:208-375-2996
Practice Address - Street 1:533 S MIDDLETON RD
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:ID
Practice Address - Zip Code:83644-6014
Practice Address - Country:US
Practice Address - Phone:208-585-6566
Practice Address - Fax:208-585-6768
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT-1954225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010150569OtherBLUE SHIELD OF IDAHO
ID2554496OtherUNITED HEALTHCARE
IDTC266OtherBLUE CROSS OF IDAHO
ID000010150569OtherBLUE SHIELD OF IDAHO