Provider Demographics
NPI:1407848070
Name:MORGAN, THOMAS J (MS, LAT,ATC,PES,EMT)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:J
Last Name:MORGAN
Suffix:
Gender:M
Credentials:MS, LAT,ATC,PES,EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 KENSLEY DR.
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-8273
Mailing Address - Country:US
Mailing Address - Phone:443-790-8078
Mailing Address - Fax:
Practice Address - Street 1:1013 CHESTNUT LN STE 120
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28104
Practice Address - Country:US
Practice Address - Phone:704-893-5487
Practice Address - Fax:704-973-0696
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00001572255A2300X
NCLAT27612255A2300X, 2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer