Provider Demographics
NPI:1255925566
Name:MORRIS, MARY KATE (PTA)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:KATE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 355
Mailing Address - Street 2:
Mailing Address - City:AULANDER
Mailing Address - State:NC
Mailing Address - Zip Code:27805-0355
Mailing Address - Country:US
Mailing Address - Phone:252-287-5784
Mailing Address - Fax:
Practice Address - Street 1:200 HAMPTON WOOD RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NC
Practice Address - Zip Code:27845
Practice Address - Country:US
Practice Address - Phone:252-534-0131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA7459225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant