Basic Information
| Provider Information | |||||||||
| NPI: | 1083040554 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MURPHY | ||||||||
| FirstName: | DONALD | ||||||||
| MiddleName: | LEE | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 35994 HELIUM ST NW | ||||||||
| Address2: | |||||||||
| City: | PRINCETON | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553715322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6124017445 | ||||||||
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| Practice Location | |||||||||
| Address1: | 911 3RD ST W | ||||||||
| Address2: | |||||||||
| City: | ASHLAND | ||||||||
| State: | WI | ||||||||
| PostalCode: | 548061311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7156828172 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2013 | ||||||||
| LastUpdateDate: | 09/17/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 12291-24 | WI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.