Healthcare Provider Details

I. General information

NPI: 1679362164
Provider Name (Legal Business Name): MORGAN HENRICKSON PT
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2025
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 INDIANAPOLIS RD
GREENCASTLE IN
46135-1458
US

IV. Provider business mailing address

600 E MAIN ST
CENTERPOINT IN
47840-8410
US

V. Phone/Fax

Practice location:
  • Phone: 765-848-1421
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number05015184A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: