Provider Demographics
NPI:1548732050
Name:MURRAY, JENNIKA ANN (DPT)
Entity type:Individual
Prefix:
First Name:JENNIKA
Middle Name:ANN
Last Name:MURRAY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JENNIKA
Other - Middle Name:
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:33900 HARPER AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-4258
Mailing Address - Country:US
Mailing Address - Phone:586-350-2644
Mailing Address - Fax:586-541-3735
Practice Address - Street 1:13350 24 MILE RD STE 500
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48315-1827
Practice Address - Country:US
Practice Address - Phone:586-997-7780
Practice Address - Fax:586-997-7781
Is Sole Proprietor?:No
Enumeration Date:2018-12-21
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501019010225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist