Provider Demographics
NPI:1982829149
Name:MURRAY, CORINA LAINEZ (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CORINA
Middle Name:LAINEZ
Last Name:MURRAY
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 1:8523 W DESERT ELM LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-3633
Mailing Address - Country:US
Mailing Address - Phone:773-255-5813
Mailing Address - Fax:
Practice Address - Street 1:8523 W DESERT ELM LN
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-3633
Practice Address - Country:US
Practice Address - Phone:773-255-5813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-14
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-32333225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK00594Medicare UPIN