Provider Demographics
NPI:1164265948
Name:MORGAN, SUMMER LYNDSEY
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:LYNDSEY
Last Name:MORGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6402 THE DIVIDE PKWY APT 104
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-5878
Mailing Address - Country:US
Mailing Address - Phone:870-584-6919
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 980
Practice Address - Street 2:
Practice Address - City:LONOKE
Practice Address - State:AR
Practice Address - Zip Code:72086-0980
Practice Address - Country:US
Practice Address - Phone:501-676-2786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPTA4910225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty