Basic Information
Provider Information
NPI: 1609257997
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MURRAY TAYLOR
FirstName: TESSA
MiddleName:  
NamePrefix: MISS
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3809 W CHESTER PIKE STE 150
Address2:  
City: NEWTOWN SQUARE
State: PA
PostalCode: 190730259
CountryCode: US
TelephoneNumber: 6103595671
FaxNumber: 6103591519
Practice Location
Address1: 119 E UWCHLAN AVE STE 201
Address2:  
City: EXTON
State: PA
PostalCode: 193411293
CountryCode: US
TelephoneNumber: 6105578182
FaxNumber: 6105942014
Other Information
ProviderEnumerationDate: 06/12/2015
LastUpdateDate: 01/30/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/30/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPTL0013351CON Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000XPT026405PAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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