Provider Demographics
NPI:1902689623
Name:MAUCK, MORGAN MARIE (DR)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:MARIE
Last Name:MAUCK
Suffix:
Gender:
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:58 PHYSICIANS DR NW STE 105
Mailing Address - Street 2:
Mailing Address - City:SUPPLY
Mailing Address - State:NC
Mailing Address - Zip Code:28462-4216
Mailing Address - Country:US
Mailing Address - Phone:703-999-7678
Mailing Address - Fax:910-406-4111
Practice Address - Street 1:58 PHYSICIANS DR NW STE 106
Practice Address - Street 2:
Practice Address - City:SUPPLY
Practice Address - State:NC
Practice Address - Zip Code:28462-4216
Practice Address - Country:US
Practice Address - Phone:910-755-5437
Practice Address - Fax:910-406-4111
Is Sole Proprietor?:No
Enumeration Date:2023-08-16
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist