Provider Demographics
NPI:1437120847
Name:MORRIS, MARY MARGARET (PT)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:MARGARET
Last Name:MORRIS
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 1:27 MEADOWBROOK LN
Mailing Address - Street 2:
Mailing Address - City:S EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02375-1201
Mailing Address - Country:US
Mailing Address - Phone:508-580-1690
Mailing Address - Fax:
Practice Address - Street 1:1 PEARL ST
Practice Address - Street 2:SUITE 1700
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-2864
Practice Address - Country:US
Practice Address - Phone:508-580-1690
Practice Address - Fax:508-580-0964
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y68127Medicare ID - Type Unspecified