Provider Demographics
NPI:1023458940
Name:MORRIS, JOHN (RPT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:MORRIS
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1691 N DAKOTA RD
Mailing Address - Street 2:PO BOX 71
Mailing Address - City:IOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66749-1581
Mailing Address - Country:US
Mailing Address - Phone:620-228-3153
Mailing Address - Fax:
Practice Address - Street 1:101 S 1ST ST
Practice Address - Street 2:
Practice Address - City:IOLA
Practice Address - State:KS
Practice Address - Zip Code:66749-3505
Practice Address - Country:US
Practice Address - Phone:620-365-1052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-00602225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist