Healthcare Provider Details

I. General information

NPI: 1467987420
Provider Name (Legal Business Name): THOMAS MORGAN C.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2017
Last Update Date: 04/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 ALPHA DR
PITTSBURGH PA
15238-2908
US

IV. Provider business mailing address

178 LACOCK ST
WASHINGTON PA
15301-2430
US

V. Phone/Fax

Practice location:
  • Phone: 412-480-6144
  • Fax:
Mailing address:
  • Phone: 724-747-3917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Z00000X
TaxonomyOrthotist
License NumberOH000009
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: