Basic Information
| Provider Information | |||||||||
| NPI: | 1881359636 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | MORGAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1337 HARDY RD STE 10 | ||||||||
| Address2: | |||||||||
| City: | VINTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 241792247 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5406478331 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1337 HARDY RD STE 10 | ||||||||
| Address2: | |||||||||
| City: | VINTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 241792247 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5406478331 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2021 | ||||||||
| LastUpdateDate: | 11/06/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 2306604120 | VA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.