=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023847555
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARY MURRAY DPT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/01/2024
-----------------------------------------------------
Last Update Date | 12/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 75 NEWPORT RD
-----------------------------------------------------
City | NEW LONDON
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03257-5467
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-526-2781
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14 KEARSARGE AVE
-----------------------------------------------------
City | CONTOOCOOK
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03229-3161
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-393-5215
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 5566
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------