Provider Demographics
NPI:1356739072
Name:DAVID MURATA LMT
Entity type:Organization
Organization Name:DAVID MURATA LMT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:NOBU-TSUNE
Authorized Official - Last Name:MURATA
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, CMMP, NCTMB,
Authorized Official - Phone:610-357-7283
Mailing Address - Street 1:213 E MANOA RD
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-4731
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1207 COUNTY LINE RD
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-2614
Practice Address - Country:US
Practice Address - Phone:610-357-7283
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG003978225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty