Provider Demographics
NPI:1669505871
Name:MURDOCK, PATRICIA (PTA)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:MURDOCK
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2685 SW 32ND PL
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-7162
Mailing Address - Country:US
Mailing Address - Phone:352-629-0033
Mailing Address - Fax:352-629-0072
Practice Address - Street 1:2685 SW 32ND PL
Practice Address - Street 2:SUITE 200
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-7162
Practice Address - Country:US
Practice Address - Phone:352-629-0033
Practice Address - Fax:352-629-0072
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA19847225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant