Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT22732 | FL |
N | 2251S0007X | Physical Therapist - Sports | PT22732 | FL |
N | 2251X0800X | Physical Therapist - Orthopedic | PT22732 | FL |
NPI | 1093839631 |
---|---|
Provider Name | Mr. Matthew T Morgan |
First Address | Bradenton, FL 34210-3506 |
Second Address | Bradenton, FL 34210-3506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 06/12/2013 |