Provider Demographics
NPI:1972852556
Name:LMURDOCH ENTERPRISES LLC
Entity Type:Organization
Organization Name:LMURDOCH ENTERPRISES LLC
Other - Org Name:MURDOCH PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORRIE
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:MURDOCH
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:888-693-4999
Mailing Address - Street 1:PO BOX 1558
Mailing Address - Street 2:
Mailing Address - City:CORTEZ
Mailing Address - State:CO
Mailing Address - Zip Code:81321-1558
Mailing Address - Country:US
Mailing Address - Phone:888-693-4999
Mailing Address - Fax:
Practice Address - Street 1:14216 ROAD 21
Practice Address - Street 2:
Practice Address - City:CORTEZ
Practice Address - State:CO
Practice Address - Zip Code:81321-8761
Practice Address - Country:US
Practice Address - Phone:888-693-4999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6981261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO09389814Medicaid
NMG8114Medicaid
8HL156Medicare UPIN