Provider Demographics
NPI:1649398991
Name:MORSE, ROBIN RAMONA (LMT)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:RAMONA
Last Name:MORSE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 S RIDGECREST AVE
Mailing Address - Street 2:
Mailing Address - City:NIXA
Mailing Address - State:MO
Mailing Address - Zip Code:65714-7803
Mailing Address - Country:US
Mailing Address - Phone:417-496-8295
Mailing Address - Fax:417-424-2552
Practice Address - Street 1:5601 S CAMPBELL AVE
Practice Address - Street 2:STE.107
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65810-2512
Practice Address - Country:US
Practice Address - Phone:417-496-8295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004021693225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist