Provider Demographics
NPI:1356568521
Name:MORRIS, WILLIAM GREGORY (OT)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:GREGORY
Last Name:MORRIS
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 DEPOT ST
Mailing Address - Street 2:
Mailing Address - City:PAINTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41240-1460
Mailing Address - Country:US
Mailing Address - Phone:606-789-7960
Mailing Address - Fax:606-789-7960
Practice Address - Street 1:106 N FRONT AVE
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-7832
Practice Address - Country:US
Practice Address - Phone:606-886-2354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR2033225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist