MEDICARE: MORGAN S CRUM PT, DPT, SCS

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	1007	NV

General Provider Information

NPI Number	:	1659386431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORGAN S CRUM PT, DPT, SCS

Provider Business Mailing Address
First Line	:	8333 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-2503
Country	:	US
Telephone Number	:	702-263-3802
Fax Number	:	702-270-7740

Provider Business Practice Location Address
First Line	:	8333 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-2503
Country	:	US
Telephone Number	:	702-263-3802
Fax Number	:	702-270-7740

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

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	05/22/2009

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