Provider Demographics
NPI:1083994396
Name:MORSE, TODD
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:
Last Name:MORSE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 COUNTRY CLUB PKWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-6043
Mailing Address - Country:US
Mailing Address - Phone:541-683-5139
Mailing Address - Fax:541-683-5783
Practice Address - Street 1:560 COUNTRY CLUB PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6043
Practice Address - Country:US
Practice Address - Phone:541-683-5139
Practice Address - Fax:541-683-5783
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR03562225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist