Provider Demographics
NPI:1558613802
Name:MORRISON, SCOTT K (LMT, AMMP)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:K
Last Name:MORRISON
Suffix:
Gender:M
Credentials:LMT, AMMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9523 S RAINTREE DR
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84092-3264
Mailing Address - Country:US
Mailing Address - Phone:801-671-1777
Mailing Address - Fax:
Practice Address - Street 1:9523 S RAINTREE DR
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84092-3264
Practice Address - Country:US
Practice Address - Phone:801-671-1777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5494519-4701225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist