Provider Demographics
NPI:1427728302
Name:MORRIS, ALLEGRA ANNE I
Entity type:Individual
Prefix:
First Name:ALLEGRA
Middle Name:ANNE
Last Name:MORRIS
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:386 COUNTY HIGHWAY 529
Mailing Address - Street 2:
Mailing Address - City:SIKESTON
Mailing Address - State:MO
Mailing Address - Zip Code:63801-7237
Mailing Address - Country:US
Mailing Address - Phone:739-979-7358
Mailing Address - Fax:
Practice Address - Street 1:1102 SIKES AVE
Practice Address - Street 2:
Practice Address - City:SIKESTON
Practice Address - State:MO
Practice Address - Zip Code:63801-5021
Practice Address - Country:US
Practice Address - Phone:573-471-5755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01363225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist