Provider Demographics
NPI:1366632234
Name:CIMALA, MORGAN DIANE (MSPT)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:DIANE
Last Name:CIMALA
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1056 S HIGHWAY 27
Mailing Address - Street 2:STE 9
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-2893
Mailing Address - Country:US
Mailing Address - Phone:606-677-1166
Mailing Address - Fax:
Practice Address - Street 1:1056 S HIGHWAY 27
Practice Address - Street 2:STE 9
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-2893
Practice Address - Country:US
Practice Address - Phone:606-677-1166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY005165225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist