Healthcare Provider Details

I. General information

NPI: 1508262106
Provider Name (Legal Business Name): KAREN MORGAN PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2014
Last Update Date: 11/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18200 E 10 MILE RD 200
EASTPOINTE MI
48021-1368
US

IV. Provider business mailing address

18200 E 10 MILE RD 200
EASTPOINTE MI
48021-1368
US

V. Phone/Fax

Practice location:
  • Phone: 586-439-2901
  • Fax: 586-439-2902
Mailing address:
  • Phone: 586-439-2901
  • Fax: 586-439-2902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number5502000657
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: