Healthcare Provider Details

I. General information

NPI: 1144000191
Provider Name (Legal Business Name): MORGAN BUNTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2023
Last Update Date: 10/09/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13385 W MCDOWELL RD
GOODYEAR AZ
85395-2631
US

IV. Provider business mailing address

4410 N 99TH AVE APT 2139
PHOENIX AZ
85037-5948
US

V. Phone/Fax

Practice location:
  • Phone: 623-986-5110
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberLPT33063
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: