Provider Demographics
NPI:1962268920
Name:MORRIS, CONNER BRENTYN (DPT)
Entity type:Individual
Prefix:DR
First Name:CONNER
Middle Name:BRENTYN
Last Name:MORRIS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3306 N MORRIS ST
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-9008
Mailing Address - Country:US
Mailing Address - Phone:503-341-1006
Mailing Address - Fax:
Practice Address - Street 1:300 NW HILLSIDE PKWY
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-9567
Practice Address - Country:US
Practice Address - Phone:503-472-9534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR65177225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist