MEDICARE: JOHN C MURRAY

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	225XP0200X	Pediatric Occupational Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972626901
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN C MURRAY

Provider Business Mailing Address
First Line	:	2612 LITTLE BEAR CT
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-6164
Country	:	US
Telephone Number	:	970-226-6225
Fax Number	:	970-226-6675

Provider Business Practice Location Address
First Line	:	1214 OAK PARK DR
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-7302
Country	:	US
Telephone Number	:	970-226-6225
Fax Number	:	970-226-6675

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN CHARLES MURRAY
Credential	:	OTR
Telephone Number	:	970-226-6225

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	08/22/2020

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