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Organization

PENINSULA PEDIATRIC THERAPY, LLC

Active
Other names
Peninsula Pediatric Therapy
Organization subpart
No

Provider details

NPI number
Authorized official
LAWRENCE J MURRAY (PHYSICAL THERAPIST)
(253) 857-5437
Entity
Organization

Contact information

Practice address
6659 KIMBALL DR, SUITE C 303, GIG HARBOR, WA 98335-5137
(253) 857-5437
(253) 857-5497
Mailing address
6659 KIMBALL DR, SUITE C 303, GIG HARBOR, WA 98335-5137
(253) 857-5437
(253) 857-5497

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT00003270
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7025612
WA
01
7206729
AETNA
WA
01
MU7914
REGENCE BLUESHIELD
WA
Enumeration date
10/13/2006
Last updated
12/22/2009
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