Provider Demographics
NPI:1144759317
Name:THE PHYSIO FIX, PLLC
Entity Type:Organization
Organization Name:THE PHYSIO FIX, PLLC
Other - Org Name:STACIE MORRIS, PT, DPT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STACIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:703-819-8767
Mailing Address - Street 1:PO BOX 71481
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-1009
Mailing Address - Country:US
Mailing Address - Phone:703-819-8767
Mailing Address - Fax:
Practice Address - Street 1:2103 W PARKSIDE LN STE 103
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-1245
Practice Address - Country:US
Practice Address - Phone:602-734-5610
Practice Address - Fax:949-553-3561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11751225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ084769OtherAHCCCS
AZ084769Medicaid
AZ022372OtherOPTUM HEALTH