Provider Demographics
NPI:1982084026
Name:LANCE, MURPHY (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:MURPHY
Middle Name:
Last Name:LANCE
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2829 N LEFEBER AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53210-1143
Mailing Address - Country:US
Mailing Address - Phone:920-251-1298
Mailing Address - Fax:
Practice Address - Street 1:7230 W HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:THIENSVILLE
Practice Address - State:WI
Practice Address - Zip Code:53092-1002
Practice Address - Country:US
Practice Address - Phone:262-242-1110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5391-26174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist