Healthcare Provider Details

I. General information

NPI: 1518219682
Provider Name (Legal Business Name): ASHLEY BROOKE MORGAN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2012
Last Update Date: 02/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 MYLAN PARK LN
MORGANTOWN WV
26501-2281
US

IV. Provider business mailing address

6 EDWIN ST
MORGANTOWN WV
26501-8505
US

V. Phone/Fax

Practice location:
  • Phone: 304-983-7766
  • Fax:
Mailing address:
  • Phone: 304-292-0173
  • Fax: 304-292-0174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT002944
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT021546
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: