Basic Information
| Provider Information | |||||||||
| NPI: | 1184332827 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MURPHY | ||||||||
| FirstName: | SAMANTHA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1687 HIDDEN TRL | ||||||||
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| City: | MAYER | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553604513 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5256475699 | ||||||||
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| Practice Location | |||||||||
| Address1: | 275 PENN AVE N | ||||||||
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| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554051216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6123774723 | ||||||||
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| ProviderEnumerationDate: | 11/11/2022 | ||||||||
| LastUpdateDate: | 11/11/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 5024 | MN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.