Provider Demographics
NPI:1851780829
Name:JENKINS, MORGAN (LMT)
Entity Type:Individual
Prefix:MS
First Name:MORGAN
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1637 OLD FORD RD
Mailing Address - Street 2:APT. 12
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-1900
Mailing Address - Country:US
Mailing Address - Phone:812-620-7691
Mailing Address - Fax:
Practice Address - Street 1:1637 OLD FORD RD
Practice Address - Street 2:APT. 12
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-1900
Practice Address - Country:US
Practice Address - Phone:812-620-7691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-14
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5254225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist