Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 40QA00560900 | NJ |
Y | 2251P0200X | Physical Therapist - Pediatrics | 40QA00560900 | NJ |
NPI | 1922620467 |
---|---|
Provider Name | Michelle Leclerc Murphy |
First Address | Oceanport, NJ 07757-1724 |
Second Address | Oceanport, NJ 07757-1724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2020 |
Last Update Date | 09/05/2020 |