Provider Demographics
NPI:1235568593
Name:MUREK, KELSIE (PT, DPT, COMT)
Entity type:Individual
Prefix:
First Name:KELSIE
Middle Name:
Last Name:MUREK
Suffix:
Gender:F
Credentials:PT, DPT, COMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORWAY
Mailing Address - State:ME
Mailing Address - Zip Code:04268-5664
Mailing Address - Country:US
Mailing Address - Phone:207-744-6160
Mailing Address - Fax:
Practice Address - Street 1:181 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORWAY
Practice Address - State:ME
Practice Address - Zip Code:04268-5664
Practice Address - Country:US
Practice Address - Phone:207-744-6160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT4041225100000X, 208100000X
MO2013038073225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation