Basic Information
Provider Information
NPI: 1730748310
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORRIS
FirstName: SAMANTHA
MiddleName: KALEEN
NamePrefix:  
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
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Mailing Information
Address1: 350 NEW FIDELITY CT
Address2:  
City: GARNER
State: NC
PostalCode: 275292665
CountryCode: US
TelephoneNumber: 9192582714
FaxNumber: 4106484878
Practice Location
Address1: 90 SOUTHSIDE AVE STE 225
Address2:  
City: ASHEVILLE
State: NC
PostalCode: 288014188
CountryCode: US
TelephoneNumber: 8282543525
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/07/2019
LastUpdateDate: 10/20/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/20/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT014501GAN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X9855SCN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000XP20266NCY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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