Healthcare Provider Details

I. General information

NPI: 1134041304
Provider Name (Legal Business Name): STEPHANIE MORGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7226B WILLIAMSON RD
ROANOKE VA
24019-4264
US

IV. Provider business mailing address

806 WASENA AVE SW APT 525
ROANOKE VA
24015-5355
US

V. Phone/Fax

Practice location:
  • Phone: 540-772-8022
  • Fax:
Mailing address:
  • Phone: 703-595-6977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305217705
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: