Provider Demographics
NPI:1972928091
Name:MORRIS, JAMIE L (DPT)
Entity Type:Individual
Prefix:MISS
First Name:JAMIE
Middle Name:L
Last Name:MORRIS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:105 PONCE DE LEON CIR
Mailing Address - Street 2:
Mailing Address - City:PONCE INLET
Mailing Address - State:FL
Mailing Address - Zip Code:32127-7205
Mailing Address - Country:US
Mailing Address - Phone:386-673-3535
Mailing Address - Fax:386-673-3530
Practice Address - Street 1:1425 HAND AVE
Practice Address - Street 2:SUITE H
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-1135
Practice Address - Country:US
Practice Address - Phone:386-673-3535
Practice Address - Fax:386-673-3530
Is Sole Proprietor?:No
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL28988225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist