Doctor Name: | MR. JACOB MORROW |
NPI Number: | 1598776379 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MPT |
License Number: | 4967 |
Business Practice Address: | 1650 Cochrane Cir Fort Carson, CO - 809134603 |
Business Phone Number: | 7195267120 |
Business Fax Number: | |
Mailing Address: | 7233 Cattle Dr, COLORADO SPRINGS |
State: | CO |
Postal Code: | 809223146 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/10/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171000000X |
License Number: | 4967 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Military Health Care Provider |
Taxonomy Specialization: | |
Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |