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General NPI Number Information
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NPI Number | 1396789459
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Entity Type | Individual
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Provider Name | MURPHY D GRANT MS, ATC, NASM-PES
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Gender | Male
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 11/14/2016
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Provider Practice Location Address
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Address Line | ATHLETICS CENTER
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City | STILLWATER
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State | OK
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Zip | 74078-0001
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Country | US
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Telephone | 405-744-6465
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Fax |
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Provider Business Mailing Address
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Address Line | 1502 S DUBLIN DR
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City | STILLWATER
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State | OK
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Zip | 74074-1620
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Country | US
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Telephone | 405-743-2529
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 303
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License Number State | OK
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