Provider Demographics
NPI:1730142829
Name:MORGAN, BONNIE LEE (PT, MED)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:LEE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:PT, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7860 DRIFTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MENTOR ON THE LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44060-2508
Mailing Address - Country:US
Mailing Address - Phone:440-257-6994
Mailing Address - Fax:
Practice Address - Street 1:6570 N RIDGE RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:OH
Practice Address - Zip Code:44057-2552
Practice Address - Country:US
Practice Address - Phone:440-428-8242
Practice Address - Fax:440-428-8243
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1245225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist