Provider Demographics
NPI:1659770402
Name:MURPHY, LAURA (ATC)
Entity Type:Individual
Prefix:MISS
First Name:LAURA
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 E MAIN ST
Mailing Address - Street 2:WHEATON COLLEGE ATHLETICS
Mailing Address - City:NORTON
Mailing Address - State:MA
Mailing Address - Zip Code:02766-2311
Mailing Address - Country:US
Mailing Address - Phone:978-621-6897
Mailing Address - Fax:
Practice Address - Street 1:26 E MAIN ST
Practice Address - Street 2:WHEATON COLLEGE ATHLETICS
Practice Address - City:NORTON
Practice Address - State:MA
Practice Address - Zip Code:02766-2311
Practice Address - Country:US
Practice Address - Phone:978-621-6897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-18
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22192255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer