Healthcare Provider Details

I. General information

NPI: 1972928091
Provider Name (Legal Business Name): JAMIE L MORRIS NEWCOMB DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2014
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5594 RIVERSIDE DR
PORT ORANGE FL
32127-5632
US

IV. Provider business mailing address

5594 RIVERSIDE DR
PORT ORANGE FL
32127-5632
US

V. Phone/Fax

Practice location:
  • Phone: 386-451-2833
  • Fax:
Mailing address:
  • Phone: 386-451-2833
  • Fax: 386-451-2833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number28988
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: