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General NPI Number Information
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NPI Number | 1194223057
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Entity Type | Individual
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Provider Name | KEVIN NELSON MURAT DC, ATC
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Gender | Male
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Dates
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Enumeration Date | 01/25/2018
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Last Update Date | 03/09/2021
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Provider Practice Location Address
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Address Line | 75 SELLECK ST
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City | STAMFORD
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State | CT
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Zip | 06902-7207
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Country | US
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Telephone | 203-149-6356
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Fax |
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Provider Business Mailing Address
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Address Line | 2289 BEDFORD ST UNIT D7
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City | STAMFORD
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State | CT
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Zip | 06905-3911
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Country | US
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Telephone | 203-816-7073
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2185
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 001066
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License Number State | CT
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