Provider Demographics
NPI:1447937842
Name:DAVIDSON, MORGAN ELIZABETH (PT, DPT, LAT, ATC)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:ELIZABETH
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:PT, DPT, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 WAVERLY DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6040
Mailing Address - Country:US
Mailing Address - Phone:919-995-3453
Mailing Address - Fax:
Practice Address - Street 1:3901 WRIGHTSVILLE AVE STE 120
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6256
Practice Address - Country:US
Practice Address - Phone:910-679-8385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-28
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP22425225100000X
NCLAT-39762255A2300X
VA2305216760225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer