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Organization
PENEMARIE K MURPHY INC
Active
Organization
PENEMARIE K MURPHY INC
Active
Parent organization
PHYSICAL THERAPY SERVICES
Other names
Physical Therapy Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHYSICAL THERAPY SERVICES
Authorized official
MRS. PENEMARIE KALLAS MURPHY P.T. (PRESIDENT)
(904) 645-7400
Entity
Organization
Contact information
Practice address
12740 ATLANTIC BLVD, SUITE 2, JACKSONVILLE, FL 32225-6111
(904) 220-8311
(904) 220-8313
Mailing address
PO BOX 11677, JACKSONVILLE, FL 32239-1677
(904) 745-0302
(904) 745-0750
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102330
AVMED
FL
01
—
5490100
AETNA
FL
05
—
880295500
—
FL
01
—
Y908W
BCBS FL
FL
Enumeration date
11/13/2006
Last updated
08/17/2009
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