Provider Demographics
NPI:1033879564
Name:SCARDINO, MORGAN (PT)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:SCARDINO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2673 E SAWYER RD
Mailing Address - Street 2:
Mailing Address - City:REPUBLIC
Mailing Address - State:MO
Mailing Address - Zip Code:65738-7574
Mailing Address - Country:US
Mailing Address - Phone:417-324-7646
Mailing Address - Fax:
Practice Address - Street 1:2673 E SAWYER RD
Practice Address - Street 2:
Practice Address - City:REPUBLIC
Practice Address - State:MO
Practice Address - Zip Code:65738-7574
Practice Address - Country:US
Practice Address - Phone:417-324-7646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-24
Last Update Date:2021-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20200243662251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics