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NPI Code Detail

MEDICARE: KOTARO TAMURA DPT

MEDICARE: KOTARO TAMURA DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT032566PA

General Provider Information

NPI Number : 1225863772
Entity Type Code : Individual
Provider Name (Legal Business Name) : KOTARO TAMURA DPT
Provider Business Mailing Address
First Line : 4025 FIELDCREST DR
Second Line :
City : BRIDGEVILLE
State : PA
Zip : 15017-3531
Country : US
Telephone Number : 201-625-3017
Fax Number :
Provider Business Practice Location Address
First Line : 3754 LIBRARY RD
Second Line :
City : PITTSBURGH
State : PA
Zip : 15234-2233
Country : US
Telephone Number : 412-854-5077
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2024
Last Update Date : 09/04/2024

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Directions to “ KOTARO TAMURA DPT” Practice Location

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