Healthcare Provider Details

I. General information

NPI: 1114123734
Provider Name (Legal Business Name): ANDREA MICHELLE COYNE-MURPHY DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANDREA COYNE

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 05/12/2020
Certification Date: 05/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 POND LANE DAMONMILL SQ
CONCORD MA
01742
US

IV. Provider business mailing address

10 WEDGEMERE ST
N BILLERICA MA
01862-1543
US

V. Phone/Fax

Practice location:
  • Phone: 978-369-9996
  • Fax: 978-371-2516
Mailing address:
  • Phone: 978-314-7308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number17933
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: