Provider Demographics
NPI:1679782874
Name:MORRIS, PHILIP MICHAEL (MAPT)
Entity type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:MICHAEL
Last Name:MORRIS
Suffix:
Gender:M
Credentials:MAPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 AUTUMN ROSE CT
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-6780
Mailing Address - Country:US
Mailing Address - Phone:636-614-2757
Mailing Address - Fax:
Practice Address - Street 1:204 AUTUMN ROSE CT
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-6780
Practice Address - Country:US
Practice Address - Phone:636-614-2757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006009610225100000X
NY003795225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist