Provider Demographics
NPI:1609487404
Name:MESCARIC, MORGAN (PT)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:MESCARIC
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:
Other - Last Name:CLIFFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:107 FIRST PARK DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04963-5367
Mailing Address - Country:US
Mailing Address - Phone:207-873-8140
Mailing Address - Fax:
Practice Address - Street 1:107 FIRST PARK DR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:ME
Practice Address - Zip Code:04963-5367
Practice Address - Country:US
Practice Address - Phone:207-873-8140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT5762225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist