Provider Demographics
NPI:1982759965
Name:MURRAY, KATHLEEN ANGELE (PT)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:ANGELE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 WILES RD
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:MA
Mailing Address - Zip Code:01564-1514
Mailing Address - Country:US
Mailing Address - Phone:978-422-7201
Mailing Address - Fax:978-422-6864
Practice Address - Street 1:10 WILES RD
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:MA
Practice Address - Zip Code:01564-1514
Practice Address - Country:US
Practice Address - Phone:978-422-7201
Practice Address - Fax:978-422-6864
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2730225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY66146OtherBCBS I.D.#