Provider Demographics
NPI:1235602467
Name:CONNOR, MORGAN MARIE
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:MARIE
Last Name:CONNOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10203 SEAMAN RD
Mailing Address - Street 2:
Mailing Address - City:CURTICE
Mailing Address - State:OH
Mailing Address - Zip Code:43412-9711
Mailing Address - Country:US
Mailing Address - Phone:419-779-5115
Mailing Address - Fax:
Practice Address - Street 1:701 N CLINTON ST
Practice Address - Street 2:
Practice Address - City:DEFIANCE
Practice Address - State:OH
Practice Address - Zip Code:43512-1610
Practice Address - Country:US
Practice Address - Phone:419-779-5115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer