Provider Demographics
NPI:1588294029
Name:MURPHY, BETHANY RAE (LMT)
Entity type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:RAE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 TAPLEY RD
Mailing Address - Street 2:
Mailing Address - City:BUXTON
Mailing Address - State:ME
Mailing Address - Zip Code:04093-6442
Mailing Address - Country:US
Mailing Address - Phone:207-852-6988
Mailing Address - Fax:
Practice Address - Street 1:7 OAK HILL TERRACE
Practice Address - Street 2:SUITE 212
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074
Practice Address - Country:US
Practice Address - Phone:207-852-6988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMT6598225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty