Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 06001203A | IN |
NPI | 1013105584 |
---|---|
Provider Name | Ms. Teresa Kay Morris |
First Address | Lafayette, IN 47905-7880 |
Second Address | West Lafayette, IN 47906-1431 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2007 |
Last Update Date | 10/10/2007 |