Provider Demographics
NPI:1386716835
Name:MORRIS, CORRINE E (PT)
Entity type:Individual
Prefix:
First Name:CORRINE
Middle Name:E
Last Name:MORRIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2935 BASELINE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-2366
Mailing Address - Country:US
Mailing Address - Phone:303-247-0028
Mailing Address - Fax:303-247-0826
Practice Address - Street 1:2935 BASELINE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-2366
Practice Address - Country:US
Practice Address - Phone:303-247-0028
Practice Address - Fax:303-247-0826
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10764225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
362877OtherMVP
06559394OtherBLUE CROSS
06559394OtherBLUE CROSS