Healthcare Provider Details

I. General information

NPI: 1386983179
Provider Name (Legal Business Name): ERIC MORSON PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2013
Last Update Date: 02/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7540 N 19TH AVE
PHOENIX AZ
85021-7967
US

IV. Provider business mailing address

PO BOX 1326
DURANGO CO
81302-1326
US

V. Phone/Fax

Practice location:
  • Phone: 888-873-4221
  • Fax:
Mailing address:
  • Phone: 970-779-3103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number10627
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: