MEDICARE: MISS JULIEANNE JOY MURPHY PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	3292	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3292	OTHER	AZ	STATE OF AZ PT LICENSE

General Provider Information

NPI Number	:	1366952590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JULIEANNE JOY MURPHY PT

Provider Business Mailing Address
First Line	:	405 W MAIN ST STE D
Second Line	:
City	:	PAYSON
State	:	AZ
Zip	:	85541-5345
Country	:	US
Telephone Number	:	928-474-0429
Fax Number	:

Provider Business Practice Location Address
First Line	:	405 W MAIN ST STE D
Second Line	:
City	:	PAYSON
State	:	AZ
Zip	:	85541-5345
Country	:	US
Telephone Number	:	928-474-0429
Fax Number	:	928-474-0199

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2017
Last Update Date	:	10/31/2017

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