Provider Demographics
NPI:1467005348
Name:MORRIS, MORGAN ASHLEY (PTA)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:ASHLEY
Last Name:MORRIS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 N FLORENCE AVE STE 330
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-3179
Mailing Address - Country:US
Mailing Address - Phone:918-342-6703
Mailing Address - Fax:918-342-7889
Practice Address - Street 1:1501 N FLORENCE AVE STE 330
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-3179
Practice Address - Country:US
Practice Address - Phone:918-342-6703
Practice Address - Fax:918-342-7889
Is Sole Proprietor?:No
Enumeration Date:2019-07-19
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2421225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant