Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | AT 9149 | CA |
NPI | 1003204330 |
---|---|
Provider Name | Agnieszka Murphy |
First Address | Fullerton, CA 92833 |
Second Address | Fullerton, CA 92833-4031 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2015 |
Last Update Date | 09/01/2015 |