Provider Demographics
NPI:1891325080
Name:MORRISSETTE, JUSTIN MARQUISE (PT)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:MARQUISE
Last Name:MORRISSETTE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1705 N GREENVILLE AVE APT 335
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-1982
Mailing Address - Country:US
Mailing Address - Phone:251-605-7915
Mailing Address - Fax:
Practice Address - Street 1:6101 WINDHAVEN PKWY STE 145
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8198
Practice Address - Country:US
Practice Address - Phone:972-473-8980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-16
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1326397225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist