Provider Demographics
NPI:1891881744
Name:MURPHY, BRENDA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20347 TIMBERLAKE RD STE B
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-7352
Mailing Address - Country:US
Mailing Address - Phone:434-352-5799
Mailing Address - Fax:434-509-1695
Practice Address - Street 1:571 COURT STREET
Practice Address - Street 2:A-C PROF BLDG
Practice Address - City:APPOMATTOX
Practice Address - State:VA
Practice Address - Zip Code:24522
Practice Address - Country:US
Practice Address - Phone:434-352-5799
Practice Address - Fax:434-509-1695
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305006744225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010149690Medicaid