Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | PT 007866 | OH |
N | 2251X0800X | Physical Therapist - Orthopedic | PT 007866 | OH |
NPI | 1083024483 |
---|---|
Provider Name | Mr. Michael Murphy |
First Address | Cleveland, OH 44113-3108 |
Second Address | Cleveland, OH 44113-3108 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2014 |
Last Update Date | 07/05/2014 |