Provider Demographics
NPI:1205661733
Name:DAVIS, MORGAN VV (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:VV
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2850 E HERMOSA WAY
Mailing Address - Street 2:
Mailing Address - City:HOLLADAY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-3726
Mailing Address - Country:US
Mailing Address - Phone:615-519-7150
Mailing Address - Fax:
Practice Address - Street 1:4668 PEMBROKE BLVD STE 115A
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-6423
Practice Address - Country:US
Practice Address - Phone:757-648-8562
Practice Address - Fax:757-648-8564
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VACP034753T225100000X
UT13984646-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist