Provider Demographics
NPI:1811961733
Name:MURRAY, JOANN (AT,C, LAT, LAC)
Entity type:Individual
Prefix:MS
First Name:JOANN
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:AT,C, LAT, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4530 E RAY RD STE 110
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-6095
Mailing Address - Country:US
Mailing Address - Phone:203-512-0572
Mailing Address - Fax:832-202-0250
Practice Address - Street 1:4530 E RAY RD STE 110
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-6095
Practice Address - Country:US
Practice Address - Phone:203-740-7500
Practice Address - Fax:203-740-1300
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZATR0014402255A2300X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer