Provider Demographics
NPI:1619405651
Name:FOGEL, MORGAN CHRISTINE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:CHRISTINE
Last Name:FOGEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3038 N ANN EVE PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-1548
Mailing Address - Country:US
Mailing Address - Phone:573-356-8075
Mailing Address - Fax:
Practice Address - Street 1:6206 E PIMA ST STE 3
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-7001
Practice Address - Country:US
Practice Address - Phone:520-733-6227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-02
Last Update Date:2017-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13041PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ13041PTOtherSTATE