Provider Demographics
NPI:1265796924
Name:MORROW, JAMES (LMT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:MORROW
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 EDGEWATER BEACH DR STE 102
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-4737
Mailing Address - Country:US
Mailing Address - Phone:863-602-1422
Mailing Address - Fax:
Practice Address - Street 1:201 N KENTUCKY AVE STE 102
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-4908
Practice Address - Country:US
Practice Address - Phone:863-602-1422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA67647225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist