Basic Information
| Provider Information | |||||||||
| NPI: | 1801246996 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | IRWIN | ||||||||
| FirstName: | MORGAN | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 520 MELROSE ST | ||||||||
| Address2: | |||||||||
| City: | MORGANTOWN | ||||||||
| State: | WV | ||||||||
| PostalCode: | 265054727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3045529459 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6000 HAMPTON CTR | ||||||||
| Address2: | SUITE B | ||||||||
| City: | MORGANTOWN | ||||||||
| State: | WV | ||||||||
| PostalCode: | 265050651 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3045991500 | ||||||||
| FaxNumber: | 3045997800 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2016 | ||||||||
| LastUpdateDate: | 05/13/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | LPT394 | WV | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225X00000X | 1837 | WV | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.