MEDICARE: MR. RODNEY MORRIS SR.

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	171400000X	Health & Wellness Coach
2	226300000X	Kinesiotherapist

General Provider Information

NPI Number	:	1710626973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RODNEY MORRIS SR.

Provider Business Mailing Address
First Line	:	8160 VETERANS PKWY APT 221
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31909-1963
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8160 VETERANS PKWY APT 221
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31909-1963
Country	:	US
Telephone Number	:	678-467-4942
Fax Number	:

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

Provider Enumeration Date	:	06/03/2022
Last Update Date	:	06/03/2022

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