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Individual
KIRK S DECKER
Active
Individual
KIRK S DECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT012509L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001768850 0002
—
PA
05
—
001768850 0003
—
PA
05
—
001768850 0004
—
PA
05
—
001768850 0005
—
PA
05
—
001768850 0006
—
PA
05
—
001768850 0007
—
PA
05
—
001768850 0008
—
PA
05
—
001768850 0011
—
PA
01
—
120494604
DEPARTMENT OF LABOR
—
01
—
12107036
CAQH
—
01
—
243225
UPMC
PA
01
—
650021492
MEDICARE RAILROAD CG7782
PA
01
—
720498
HIGHMARK BLUE CROSS BLUE SHIELD
—
Enumeration date
08/26/2005
Last updated
07/08/2015
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