Provider Demographics
NPI:1295068922
Name:MURPHY, FERN ROBIN (LMT)
Entity type:Individual
Prefix:MRS
First Name:FERN
Middle Name:ROBIN
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PELICAN LN
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:FL
Mailing Address - Zip Code:32141-4219
Mailing Address - Country:US
Mailing Address - Phone:386-690-1943
Mailing Address - Fax:386-690-1943
Practice Address - Street 1:3 PELICAN LN
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:FL
Practice Address - Zip Code:32141-4219
Practice Address - Country:US
Practice Address - Phone:386-690-1943
Practice Address - Fax:386-690-1943
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA29343172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist