Healthcare Provider Details

I. General information

NPI: 1851312466
Provider Name (Legal Business Name): CRAIG MAARTMANN-MOE DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 03/16/2023
Certification Date: 03/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9365 MCKNIGHT RD STE 300
PITTSBURGH PA
15237-5901
US

IV. Provider business mailing address

9365 MCKNIGHT RD STE 300
PITTSBURGH PA
15237-5901
US

V. Phone/Fax

Practice location:
  • Phone: 412-630-9750
  • Fax: 412-630-9761
Mailing address:
  • Phone: 412-630-9750
  • Fax: 412-630-9761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT017404
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT017404
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: