Provider Demographics
NPI:1689280968
Name:PLUMMER, MORGAN DANIELLE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:DANIELLE
Last Name:PLUMMER
Suffix:
Gender:F
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 1:327 N BOYLSTON ST
Mailing Address - Street 2:APT 221
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-4678
Mailing Address - Country:US
Mailing Address - Phone:614-546-7339
Mailing Address - Fax:
Practice Address - Street 1:330 MISSION RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-3328
Practice Address - Country:US
Practice Address - Phone:614-546-7339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-22
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA299112225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist