Provider Demographics
NPI:1326003971
Name:MORSE, GLORIA E (PT)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:E
Last Name:MORSE
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:PO BOX 1886
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83303-1886
Mailing Address - Country:US
Mailing Address - Phone:208-736-0887
Mailing Address - Fax:208-736-0890
Practice Address - Street 1:119 BROADWAY AVE N
Practice Address - Street 2:
Practice Address - City:BUHL
Practice Address - State:ID
Practice Address - Zip Code:83316-1622
Practice Address - Country:US
Practice Address - Phone:208-543-5746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT-886225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010026641OtherREGENCE
ID805326200Medicaid
IDT8869OtherBLUE CROSS