Provider Demographics
NPI:1891136214
Name:MURPHY, LORETTA (LMT, CLT, CPMT)
Entity Type:Individual
Prefix:
First Name:LORETTA
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LMT, CLT, CPMT
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT, CLT, CPMT
Mailing Address - Street 1:971 RESERVOIR AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-5134
Mailing Address - Country:US
Mailing Address - Phone:401-954-5959
Mailing Address - Fax:401-946-5457
Practice Address - Street 1:62 GARLAND AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-4223
Practice Address - Country:US
Practice Address - Phone:401-954-5959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-14
Last Update Date:2013-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMT00892225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist