Provider Demographics
NPI:1750545372
Name:MURTHA, TRACEY C (PT)
Entity type:Individual
Prefix:MRS
First Name:TRACEY
Middle Name:C
Last Name:MURTHA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 S MARTHA CT
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7359
Mailing Address - Country:US
Mailing Address - Phone:615-309-8781
Mailing Address - Fax:
Practice Address - Street 1:1610 S MARTHA CT
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-7359
Practice Address - Country:US
Practice Address - Phone:615-309-8781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-13
Last Update Date:2008-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001910225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist