MEDICARE: MRS. ELIZABETH TREAT MORRIS P.T.

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	102085-2401	UT
2	225700000X	Massage Therapist	102733-4701	UT

General Provider Information

NPI Number	:	1891976452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH TREAT MORRIS P.T.

Provider Business Mailing Address
First Line	:	PO BOX 526186
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84152-6186
Country	:	US
Telephone Number	:	801-272-3118
Fax Number	:	801-277-9724

Provider Business Practice Location Address
First Line	:	4177 MATHEWS WAY
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84124-4021
Country	:	US
Telephone Number	:	801-272-3118
Fax Number	:	801-277-9724

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

Provider Enumeration Date	:	11/23/2007
Last Update Date	:	11/23/2007

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