=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922729698
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DEVON MORRIS DPT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/09/2022
-----------------------------------------------------
Last Update Date | 01/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1495 NORTHSIDE DR NW STE A
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30318-4200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 470-823-2030
-----------------------------------------------------
Fax | 470-823-2031
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 33900 HARPER AVE STE 104
-----------------------------------------------------
City | CLINTON TWP
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48035-4258
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | PT016245
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------