Provider Demographics
NPI:1851654594
Name:NALLE, MORRIS ANTHONY (PT)
Entity Type:Individual
Prefix:MR
First Name:MORRIS
Middle Name:ANTHONY
Last Name:NALLE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:19 CLOVELLY ST
Mailing Address - Street 2:APT 1106
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-6936
Mailing Address - Country:US
Mailing Address - Phone:443-435-0616
Mailing Address - Fax:
Practice Address - Street 1:1120 SAINT PAUL ST
Practice Address - Street 2:GROUND LEVEL
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2618
Practice Address - Country:US
Practice Address - Phone:410-685-7790
Practice Address - Fax:410-685-7851
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD16597225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist