MEDICARE: CAROL MORLEY

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	225200000X	Physical Therapy Assistant	PTA 19428	FL

General Provider Information

NPI Number	:	1366894917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL MORLEY

Provider Business Mailing Address
First Line	:	6002 TANGELO DR
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-7502
Country	:	US
Telephone Number	:	772-284-6705
Fax Number	:

Provider Business Practice Location Address
First Line	:	2401 PGA BLVD STE 155
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-3516
Country	:	US
Telephone Number	:	561-249-2958
Fax Number	:

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

Provider Enumeration Date	:	07/07/2016
Last Update Date	:	07/07/2016

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