Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225700000X | Massage Therapist | MA9748 | FL |
N | 226300000X | Kinesiotherapist |
NPI | 1023044138 |
---|---|
Provider Name | John A Murray |
First Address | Lutz, FL 33549-9333 |
Second Address | Tampa, FL 33612-4745 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 08/07/2007 |