Healthcare Provider Details

I. General information

NPI: 1467886309
Provider Name (Legal Business Name): ESMERALDA MENDOZA MORRISON PT, DPT, AT-RET
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2013
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2817 ROCK MERRITT AVE
FORT BRAGG NC
28310-0001
US

IV. Provider business mailing address

2817 ROCK MERRITT AVE
FORT BRAGG NC
28310-0001
US

V. Phone/Fax

Practice location:
  • Phone: 910-907-8707
  • Fax: 910-907-6069
Mailing address:
  • Phone: 910-907-8707
  • Fax: 910-907-6069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP14521
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: