Provider Demographics
NPI:1558995142
Name:CRUTCHFIELD, MORGAN SHEA (DPT)
Entity Type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:SHEA
Last Name:CRUTCHFIELD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:MORGAN
Other - Middle Name:SHEA
Other - Last Name:STERKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1497 GREYFIELD DR
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092-5019
Mailing Address - Country:US
Mailing Address - Phone:352-256-3496
Mailing Address - Fax:
Practice Address - Street 1:1000 W BROADWAY ST STE 214
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-9262
Practice Address - Country:US
Practice Address - Phone:407-359-5693
Practice Address - Fax:407-792-5693
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT27306225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist