Provider Demographics
NPI:1255098836
Name:RICHARDS, MORGAN SHADE (DPT)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:SHADE
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:
Other - Last Name:SHADE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:805 N RICHMOND ST STE 103
Mailing Address - Street 2:
Mailing Address - City:FLEETWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19522-1059
Mailing Address - Country:US
Mailing Address - Phone:610-944-8140
Mailing Address - Fax:
Practice Address - Street 1:805 N RICHMOND ST STE 103
Practice Address - Street 2:
Practice Address - City:FLEETWOOD
Practice Address - State:PA
Practice Address - Zip Code:19522-1059
Practice Address - Country:US
Practice Address - Phone:610-944-8140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-18
Last Update Date:2023-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist