Provider Demographics
NPI:1134432651
Name:MOREHOUSE, TRISHA J (OD)
Entity type:Individual
Prefix:MS
First Name:TRISHA
Middle Name:J
Last Name:MOREHOUSE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 20TH ST S
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-4671
Mailing Address - Country:US
Mailing Address - Phone:605-627-1212
Mailing Address - Fax:605-627-1313
Practice Address - Street 1:606 20TH ST S
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-4671
Practice Address - Country:US
Practice Address - Phone:605-627-1212
Practice Address - Fax:605-627-1313
Is Sole Proprietor?:No
Enumeration Date:2010-07-26
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD665152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist