Provider Demographics
NPI:1104955004
Name:MURRAY, MEEGAN LEE (MPT)
Entity type:Individual
Prefix:MRS
First Name:MEEGAN
Middle Name:LEE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MS
Other - First Name:MEEGAN
Other - Middle Name:LEE
Other - Last Name:CRAMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MPT
Mailing Address - Street 1:1095 TEXAS PALMYRA HWY STE 1
Mailing Address - Street 2:
Mailing Address - City:HONESDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18431-7687
Mailing Address - Country:US
Mailing Address - Phone:570-616-0665
Mailing Address - Fax:570-616-0669
Practice Address - Street 1:1095 TEXAS PALMYRA HWY STE 1
Practice Address - Street 2:
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431-7687
Practice Address - Country:US
Practice Address - Phone:570-616-0665
Practice Address - Fax:570-616-0669
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016851225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1036450200001Medicaid