Provider Demographics
NPI:1598927725
Name:MURPHY, JOHNNY RICHARD II (PTA)
Entity Type:Individual
Prefix:MR
First Name:JOHNNY
Middle Name:RICHARD
Last Name:MURPHY
Suffix:II
Gender:M
Credentials:PTA
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 57
Mailing Address - Street 2:
Mailing Address - City:COLDIRON
Mailing Address - State:KY
Mailing Address - Zip Code:40819-0057
Mailing Address - Country:US
Mailing Address - Phone:606-664-2434
Mailing Address - Fax:
Practice Address - Street 1:19101 N US HIGHWAY 119
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:KY
Practice Address - Zip Code:40823-8107
Practice Address - Country:US
Practice Address - Phone:606-589-5421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-29
Last Update Date:2008-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA01682225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant