Provider Demographics
NPI:1871513879
Name:MURPHY, DENISE MICHELLE (RPT)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:MICHELLE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BROOKS PL
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81001-1711
Mailing Address - Country:US
Mailing Address - Phone:719-296-6163
Mailing Address - Fax:719-296-6179
Practice Address - Street 1:1300 FORTINO BLVD STE E
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-2076
Practice Address - Country:US
Practice Address - Phone:719-296-6163
Practice Address - Fax:719-296-6179
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5179225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist