Organization Name: | KTM LLC |
NPI Number: | 1053757674 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KATHLEEN T MURRAY (OWNER) |
Mailing Address: | 320 Cedar Waxwing Dr Warrington |
State: | PA US |
Postal Code: | 189763021 |
Phone Number: | 2152069491 |
Fax Number: | |
NPI Enumeration Date: | 05/22/2013 |
NPI Last Update Date: | 05/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | TP005382C |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |