Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 2017043585 | MO |
NPI | 1073012316 |
---|---|
Provider Name | Dr. Bradley Christian Morr |
First Address | Farmington, MO 63640-1323 |
Second Address | Farmington, MO 63640-1323 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2018 |
Last Update Date | 01/02/2018 |