Provider Demographics
NPI:1841670494
Name:MORGAN, RICHARD (DPT)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:MORGAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 3RD ST NW
Mailing Address - Street 2:
Mailing Address - City:EAST GRAND FORKS
Mailing Address - State:MN
Mailing Address - Zip Code:56721-1713
Mailing Address - Country:US
Mailing Address - Phone:218-773-3388
Mailing Address - Fax:218-773-6611
Practice Address - Street 1:406 3RD ST NW
Practice Address - Street 2:
Practice Address - City:EAST GRAND FORKS
Practice Address - State:MN
Practice Address - Zip Code:56721-1713
Practice Address - Country:US
Practice Address - Phone:218-773-3388
Practice Address - Fax:218-773-6611
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1982225100000X
MN10964225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1841670494OtherNPI
ND1841670494OtherNPI