Healthcare Provider Details

I. General information

NPI: 1497418560
Provider Name (Legal Business Name): MORGAN BETHANNE BLODGETT DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MORGAN BETHANNE PERRIN DPT

II. Dates (important events)

Enumeration Date: 10/15/2021
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 PARRISH ST STE 220
CANANDAIGUA NY
14424-1791
US

IV. Provider business mailing address

229 PARRISH ST STE 220
CANANDAIGUA NY
14424-1791
US

V. Phone/Fax

Practice location:
  • Phone: 585-394-3920
  • Fax: 585-394-3997
Mailing address:
  • Phone: 585-394-3920
  • Fax: 585-394-3997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number28707
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number303979
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number188544
License Number StateAK
# 5
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number047758
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: