MEDICARE: ANGIE LYNN MORROW DPT

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	PT2759	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	5Y661	OTHER	AR	BCBS

General Provider Information

NPI Number	:	1619931912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGIE LYNN MORROW DPT

Provider Business Mailing Address
First Line	:	24711 HIGHWAY 5
Second Line	:
City	:	LONSDALE
State	:	AR
Zip	:	72087-9005
Country	:	US
Telephone Number	:	501-922-9933
Fax Number	:	501-922-9934

Provider Business Practice Location Address
First Line	:	4585 N HIGHWAY 7 STE 10
Second Line	:
City	:	HOT SPRINGS VILLAGE
State	:	AR
Zip	:	71909-9490
Country	:	US
Telephone Number	:	501-204-5095
Fax Number	:	501-204-5096

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

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	03/05/2020

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