MEDICARE: MRS. KRISTIE R MCMURRAY OTR/L

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	225X00000X	Occupational Therapist	1163	NV

General Provider Information

NPI Number	:	1588820088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTIE R MCMURRAY OTR/L

Provider Business Mailing Address
First Line	:	3334 HILLSIDE GARDEN DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-2829
Country	:	US
Telephone Number	:	702-207-1021
Fax Number	:

Provider Business Practice Location Address
First Line	:	1181 S BUFFALO DR
Second Line	:	SUITE 105
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-8311
Country	:	US
Telephone Number	:	702-360-1137
Fax Number	:

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

Provider Enumeration Date	:	08/04/2008
Last Update Date	:	08/05/2008

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