Provider Demographics
NPI:1861067027
Name:LAVIOLETTE, MORGAN RAE (PT, DPT, CERTDN)
Entity type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:RAE
Last Name:LAVIOLETTE
Suffix:
Gender:F
Credentials:PT, DPT, CERTDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 W 32ND ST STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1918
Mailing Address - Country:US
Mailing Address - Phone:512-324-3580
Mailing Address - Fax:512-324-3581
Practice Address - Street 1:1004 W 32ND ST STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1918
Practice Address - Country:US
Practice Address - Phone:512-324-3580
Practice Address - Fax:512-324-3581
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1335398225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist