Provider Demographics
NPI:1699475749
Name:MORROW, KENNETH E III (LMT)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:E
Last Name:MORROW
Suffix:III
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 PORTAGE LAKES DR STE 1
Mailing Address - Street 2:
Mailing Address - City:COVENTRY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:44319-2269
Mailing Address - Country:US
Mailing Address - Phone:330-474-9844
Mailing Address - Fax:
Practice Address - Street 1:503 PORTAGE LAKES DR STE 1
Practice Address - Street 2:
Practice Address - City:COVENTRY TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:44319-2269
Practice Address - Country:US
Practice Address - Phone:330-474-9844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-07
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020900225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty