Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1043785108 |
---|---|
Provider Name | Cody Murphy |
First Address | Amargosa Valley, NV 89020-1514 |
Second Address | Amargosa Valley, NV 89020-1514 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2018 |
Last Update Date | 04/10/2018 |