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NPI Code Detail

MEDICARE: PAUL MURRAY DPT

MEDICARE: PAUL MURRAY DPT
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
1225100000XPhysical Therapist2830NE
2225100000XPhysical Therapist0004391IA

General Provider Information

NPI Number : 1639305717
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL MURRAY DPT
Provider Business Mailing Address
First Line : 2403 S 133RD PLZ
Second Line :
City : OMAHA
State : NE
Zip : 68144-5905
Country : US
Telephone Number : 402-330-8433
Fax Number : 402-330-8616
Provider Business Practice Location Address
First Line : 7818 DODGE ST
Second Line :
City : OMAHA
State : NE
Zip : 68114-3412
Country : US
Telephone Number : 402-493-6808
Fax Number : 402-493-6979
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2009
Last Update Date : 02/08/2010

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