Healthcare Provider Details

I. General information

NPI: 1912193400
Provider Name (Legal Business Name): ROBERT MORGIA PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2007
Last Update Date: 09/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 BEVERLY DR
CHESTERTON IN
46304-9368
US

IV. Provider business mailing address

248 WHITE THORNE LN
VALPARAISO IN
46383-9785
US

V. Phone/Fax

Practice location:
  • Phone: 219-926-8367
  • Fax: 847-441-0734
Mailing address:
  • Phone: 219-926-8387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number05003278A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: