Provider Demographics
NPI:1396811782
Name:MORGAN, JAMIE M (PT)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:M
Last Name:MORGAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 MILL SPRING LN
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-7024
Mailing Address - Country:US
Mailing Address - Phone:314-560-7270
Mailing Address - Fax:
Practice Address - Street 1:1840 ZUMBEHL RD
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-2761
Practice Address - Country:US
Practice Address - Phone:636-947-7678
Practice Address - Fax:636-947-4350
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOPTL-8301OtherLICENSE#
MOPTL-8301OtherLICENSE#