Provider Demographics
NPI:1730292640
Name:MURDOCH, EDITH GAIL (MPT, CWS)
Entity Type:Individual
Prefix:
First Name:EDITH
Middle Name:GAIL
Last Name:MURDOCH
Suffix:
Gender:F
Credentials:MPT, CWS
Other - Prefix:MS
Other - First Name:EDIE
Other - Middle Name:
Other - Last Name:MURDOCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MPT, CWS
Mailing Address - Street 1:2403 N GRANT ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-3601
Mailing Address - Country:US
Mailing Address - Phone:501-257-6489
Mailing Address - Fax:
Practice Address - Street 1:4300 W 7TH ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5446
Practice Address - Country:US
Practice Address - Phone:501-257-6489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00007402225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist