Provider Demographics
NPI:1548582471
Name:MURTHA, MELISSA GAYLE (LAC, MSTOM)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:GAYLE
Last Name:MURTHA
Suffix:
Gender:F
Credentials:LAC, MSTOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 PITTSBURGH ST
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-2772
Mailing Address - Country:US
Mailing Address - Phone:724-366-0401
Mailing Address - Fax:
Practice Address - Street 1:105 BIERER LN
Practice Address - Street 2:UPPER LEVEL
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-3117
Practice Address - Country:US
Practice Address - Phone:724-439-1088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-19
Last Update Date:2012-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK000974171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA12367266OtherCAQH ID