Provider Demographics
NPI:1578947164
Name:MORRIS, NEIL (PT, DPT)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:
Last Name:MORRIS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2861
Mailing Address - Country:US
Mailing Address - Phone:208-215-2210
Mailing Address - Fax:208-215-2209
Practice Address - Street 1:301 N 3RD ST
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814
Practice Address - Country:US
Practice Address - Phone:208-215-2210
Practice Address - Fax:208-215-2209
Is Sole Proprietor?:No
Enumeration Date:2015-07-14
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT-3950225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist