Provider Demographics
NPI:1891947974
Name:MURRAY, CARRON ANN (PTA)
Entity Type:Individual
Prefix:MS
First Name:CARRON
Middle Name:ANN
Last Name:MURRAY
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 1:221 W MARYDALE AVE
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7420
Mailing Address - Country:US
Mailing Address - Phone:907-262-2596
Mailing Address - Fax:907-262-2765
Practice Address - Street 1:221 W MARYDALE AVE
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7420
Practice Address - Country:US
Practice Address - Phone:907-262-2596
Practice Address - Fax:907-262-2765
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1998225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant