Provider Demographics
NPI:1134550205
Name:MURPHY, LAURA H (PTA)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:H
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:B
Other - Last Name:HALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:455 BRAYTON AVE
Mailing Address - Street 2:SOMERSET RIDGE CENTER
Mailing Address - City:SOMERSET
Mailing Address - State:MA
Mailing Address - Zip Code:02726
Mailing Address - Country:US
Mailing Address - Phone:508-679-2240
Mailing Address - Fax:508-679-2983
Practice Address - Street 1:455 BRAYTON AVE
Practice Address - Street 2:SOMERSET RIDGE CENTER
Practice Address - City:SOMERSET
Practice Address - State:MA
Practice Address - Zip Code:02726
Practice Address - Country:US
Practice Address - Phone:508-679-2240
Practice Address - Fax:508-679-2983
Is Sole Proprietor?:No
Enumeration Date:2013-11-27
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPTA00943225200000X
MA8839225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant