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General NPI Number Information
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NPI Number | 1699233072
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Entity Type | Individual
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Provider Name | RYLIE M MURRAY ATC
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Gender | Female
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Dates
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Enumeration Date | 03/05/2019
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Last Update Date | 03/02/2022
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Provider Practice Location Address
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Address Line | 1047 CENTURY DR
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City | EDWARDSVILLE
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State | IL
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Zip | 62025-3772
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Country | US
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Telephone | 618-307-3434
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Fax | 618-307-3435
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Provider Business Mailing Address
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Address Line | 106 TIMBERWOOD LN
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City | COLLINSVILLE
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State | IL
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Zip | 62234-6862
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Country | US
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Telephone | 618-444-9074
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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 |
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2021035315
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 096005384
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License Number State | IL
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