Provider Demographics
NPI:1770588329
Name:MURRAY, CHERYL (LPT)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1591 COLEMAN DR
Mailing Address - Street 2:
Mailing Address - City:HUMBOLDT
Mailing Address - State:TN
Mailing Address - Zip Code:38343-1993
Mailing Address - Country:US
Mailing Address - Phone:731-784-8101
Mailing Address - Fax:731-784-7101
Practice Address - Street 1:1591 COLEMAN DR
Practice Address - Street 2:
Practice Address - City:HUMBOLDT
Practice Address - State:TN
Practice Address - Zip Code:38343-1993
Practice Address - Country:US
Practice Address - Phone:731-784-8101
Practice Address - Fax:731-784-7101
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-20
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6094225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3658509Medicare ID - Type Unspecified