Provider Demographics
NPI:1770717415
Name:MURPHY, RENEE L (MPT)
Entity type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:L
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 NORTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-6737
Mailing Address - Country:US
Mailing Address - Phone:910-540-2161
Mailing Address - Fax:910-452-8666
Practice Address - Street 1:405 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6737
Practice Address - Country:US
Practice Address - Phone:910-540-2161
Practice Address - Fax:910-452-8666
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-10
Last Update Date:2009-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC91082251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics