Provider Demographics
NPI:1457848822
Name:MORRISON, NATHAN ALLEN (LMT, NMT)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:ALLEN
Last Name:MORRISON
Suffix:
Gender:M
Credentials:LMT, NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 E RIVER RD APT 115
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5604
Mailing Address - Country:US
Mailing Address - Phone:740-398-8966
Mailing Address - Fax:
Practice Address - Street 1:7225 N PASEO DEL NORTE STE 8
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-4412
Practice Address - Country:US
Practice Address - Phone:740-398-8966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-20
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-24491225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist