MEDICARE: MS. NANCY FORD MORGAN PT

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	225100000X	Physical Therapist	2305005744	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00385939	OTHER	VA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	7314740	OTHER	VA	AETNA

General Provider Information

NPI Number	:	1407846488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NANCY FORD MORGAN PT

Provider Business Mailing Address
First Line	:	1068 LACASA COURT
Second Line	:
City	:	MONETA
State	:	VA
Zip	:	24121
Country	:	US
Telephone Number	:	540-521-5514
Fax Number	:

Provider Business Practice Location Address
First Line	:	4064 POSTAL DR
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24018-6438
Country	:	US
Telephone Number	:	540-776-0200
Fax Number	:	540-777-5850

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

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	07/10/2007

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