MEDICARE: MATTHEW MORGAN OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	8595	NC

General Provider Information

NPI Number	:	1275875684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW MORGAN OTR/L

Provider Business Mailing Address
First Line	:	5001 LONG POINTE RD
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28409-8568
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6626 GORDON RD
Second Line	:	SUITE H
City	:	WILMINGTON
State	:	NC
Zip	:	28411-8423
Country	:	US
Telephone Number	:	910-791-4051
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2013
Last Update Date	:	03/24/2013

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