Provider Demographics
NPI:1912177825
Name:MURRAY, KIMBERLY MICHELLE (PTA)
Entity Type:Individual
Prefix:MISS
First Name:KIMBERLY
Middle Name:MICHELLE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2400 PORTRUSH DR
Mailing Address - Street 2:APARTMENT 7
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29301-3334
Mailing Address - Country:US
Mailing Address - Phone:864-415-5927
Mailing Address - Fax:
Practice Address - Street 1:2006 PELHAM RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4005
Practice Address - Country:US
Practice Address - Phone:864-491-3680
Practice Address - Fax:484-813-6126
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2244225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant