Healthcare Provider Details

I. General information

NPI: 1336103654
Provider Name (Legal Business Name): THOMAS MURT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 06/15/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5855 STEUBENVILLE PIKE SUITE 100
MC KEES ROCKS PA
15136-1356
US

IV. Provider business mailing address

109 BOYLE AVE SUITE 100
CANONSBURG PA
15317-1512
US

V. Phone/Fax

Practice location:
  • Phone: 412-788-4035
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT013102L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: