Provider Demographics
NPI:1710634647
Name:NEWMAN, MORGAN LYN (DPT)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:LYN
Last Name:NEWMAN
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 1:320 SHANNON AVE
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64089-8271
Mailing Address - Country:US
Mailing Address - Phone:402-980-8315
Mailing Address - Fax:
Practice Address - Street 1:4700 NW CLIFF VIEW DR
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:MO
Practice Address - Zip Code:64150-1237
Practice Address - Country:US
Practice Address - Phone:816-741-5150
Practice Address - Fax:816-741-9470
Is Sole Proprietor?:No
Enumeration Date:2022-03-10
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019021043225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist