Provider Demographics
NPI:1972074953
Name:MURPHY, JAMES L (RPT)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:L
Last Name:MURPHY
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60360 KUNSTMAN RD
Mailing Address - Street 2:
Mailing Address - City:RAY
Mailing Address - State:MI
Mailing Address - Zip Code:48096-3615
Mailing Address - Country:US
Mailing Address - Phone:586-894-3817
Mailing Address - Fax:
Practice Address - Street 1:60360 KUNSTMAN RD
Practice Address - Street 2:
Practice Address - City:RAY
Practice Address - State:MI
Practice Address - Zip Code:48096-3615
Practice Address - Country:US
Practice Address - Phone:586-894-3817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501002265225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501002265OtherMICHIGAN PHYSICAL THERAPY LICENSE