Provider Demographics
NPI:1619931912
Name:MORROW, ANGIE LYNN (DPT)
Entity Type:Individual
Prefix:
First Name:ANGIE
Middle Name:LYNN
Last Name:MORROW
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 1:24711 HIGHWAY 5
Mailing Address - Street 2:
Mailing Address - City:LONSDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72087-9005
Mailing Address - Country:US
Mailing Address - Phone:501-922-9933
Mailing Address - Fax:501-922-9934
Practice Address - Street 1:4585 N HIGHWAY 7 STE 10
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS VILLAGE
Practice Address - State:AR
Practice Address - Zip Code:71909-9490
Practice Address - Country:US
Practice Address - Phone:501-204-5095
Practice Address - Fax:501-204-5096
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT2759225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR157422721Medicaid
AR5Y661OtherBCBS
AR5Y661Medicare ID - Type Unspecified