Provider Demographics
NPI:1053653196
Name:MORGHEIM, SHAD
Entity type:Individual
Prefix:DR
First Name:SHAD
Middle Name:
Last Name:MORGHEIM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 ALICE SPRINGS CIR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-8550
Mailing Address - Country:US
Mailing Address - Phone:303-514-1599
Mailing Address - Fax:
Practice Address - Street 1:1011 ALICE SPRINGS CIR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-8550
Practice Address - Country:US
Practice Address - Phone:303-514-1599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist