Individual
DR. HEATHER MOURTACOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
631 N BROAD STREET EXT, GROVE CITY, PA 16127-4603
(724) 450-7150
Mailing address
15 ELLIOT RD, WEST MIDDLESEX, PA 16159-2003
(412) 527-8105
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OS013888
PA
207LA0401X
Addiction Medicine (Anesthesiology) Physician
OS013888
PA
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
34.012768CTR
OH
208D00000X
General Practice Physician
34.012768CTR
OH
208D00000X
General Practice Physician
OS013888
PA
Other
Enumeration date
05/22/2007
Last updated
08/22/2024
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