Provider Demographics
NPI:1023316106
Name:MURRAY, ISAAC (LMT)
Entity type:Individual
Prefix:
First Name:ISAAC
Middle Name:
Last Name:MURRAY
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 51522
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85208-0077
Mailing Address - Country:US
Mailing Address - Phone:480-559-4066
Mailing Address - Fax:
Practice Address - Street 1:7130 W CHANDLER BLVD
Practice Address - Street 2:STE 19
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-3241
Practice Address - Country:US
Practice Address - Phone:480-559-4066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-15419225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist