Provider Demographics
NPI:1699704080
Name:MUIR, MARK (MSPT, CERTMDT)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:
Last Name:MUIR
Suffix:
Gender:M
Credentials:MSPT, CERTMDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 STRAWBRIDGE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-4602
Mailing Address - Country:US
Mailing Address - Phone:856-677-4000
Mailing Address - Fax:856-234-3014
Practice Address - Street 1:740 MARNE HWY STE 203
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3127
Practice Address - Country:US
Practice Address - Phone:856-914-1400
Practice Address - Fax:856-914-1444
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT008648L225100000X
PADAPT003483225100000X
NJ40QA01146500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ088620Medicare PIN