Provider Demographics
NPI:1760244636
Name:LYLE, MORGAN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:LYLE
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:PO BOX 124
Mailing Address - Street 2:
Mailing Address - City:GALLMAN
Mailing Address - State:MS
Mailing Address - Zip Code:39077-0124
Mailing Address - Country:US
Mailing Address - Phone:866-808-4133
Mailing Address - Fax:866-849-2728
Practice Address - Street 1:2101 RAHLING ROAD
Practice Address - Street 2:SUITE B
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-7507
Practice Address - Country:US
Practice Address - Phone:866-808-4133
Practice Address - Fax:866-849-2728
Is Sole Proprietor?:No
Enumeration Date:2024-01-26
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
ARPT5198225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist