Provider Demographics
NPI:1992874770
Name:MAUNGYOO, MORGAN ELIZABETH (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:ELIZABETH
Last Name:MAUNGYOO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MS
Other - First Name:MORGAN
Other - Middle Name:ELIZABETH
Other - Last Name:BONESTELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:3001 EDWARDS MILL RD
Mailing Address - Street 2:200
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-5243
Mailing Address - Country:US
Mailing Address - Phone:919-781-4060
Mailing Address - Fax:919-781-5246
Practice Address - Street 1:1325 TIMBER DR E
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-6924
Practice Address - Country:US
Practice Address - Phone:919-863-6991
Practice Address - Fax:919-863-6990
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10252225100000X
NY027545-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist