MEDICARE: KEVIN M MURTHY 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
1	225100000X	Physical Therapist	05012577A	IN

General Provider Information

NPI Number	:	1598289381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN M MURTHY DPT

Provider Business Mailing Address
First Line	:	151 S EAST ST APT 204
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-4077
Country	:	US
Telephone Number	:	440-525-4141
Fax Number	:

Provider Business Practice Location Address
First Line	:	8550 NAAB RD STE 100
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-2086
Country	:	US
Telephone Number	:	317-338-3364
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2017
Last Update Date	:	08/02/2017

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