Provider Demographics
NPI:1407284599
Name:PASSMORE, JAMES MORRIS (DPT, OCS, FAAOMPT)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MORRIS
Last Name:PASSMORE
Suffix:
Gender:M
Credentials:DPT, OCS, FAAOMPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 MISSILE AVE
Mailing Address - Street 2:
Mailing Address - City:MINOT AFB
Mailing Address - State:ND
Mailing Address - Zip Code:58705
Mailing Address - Country:US
Mailing Address - Phone:701-723-5633
Mailing Address - Fax:
Practice Address - Street 1:194 MISSILE AVE
Practice Address - Street 2:
Practice Address - City:MINOT AFB
Practice Address - State:ND
Practice Address - Zip Code:58705
Practice Address - Country:US
Practice Address - Phone:701-723-5633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-28
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1232526225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist