=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669401915
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIE REBECCA MURPHY ATC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/30/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2 WEST ST
-----------------------------------------------------
City | OXFORD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06478-1938
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-881-5266
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 538 CHIPPENDALE LN
-----------------------------------------------------
City | ORANGE
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06477-2525
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-795-8875
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2255A2300X
-----------------------------------------------------
Taxonomy Name | Athletic Trainer
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------