Provider Demographics
NPI:1083908016
Name:WILLIAMS, MORGAN MICHELLE (PTA)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:MICHELLE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:MICHELLE
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8823 PRODUCTION LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6511
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:936 US HIGHWAY 72 E
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-4318
Practice Address - Country:US
Practice Address - Phone:256-230-1252
Practice Address - Fax:256-230-1256
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPTA4923225200000X
ALPTA7400225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant