Provider Demographics
NPI:1629201660
Name:MORRISON, SCOTT ALAN (MASSAGE THERAPIST)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:ALAN
Last Name:MORRISON
Suffix:
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12909 N 56TH ST
Mailing Address - Street 2:STE 105
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-1275
Mailing Address - Country:US
Mailing Address - Phone:813-989-0861
Mailing Address - Fax:813-464-7645
Practice Address - Street 1:12909 N 56TH ST
Practice Address - Street 2:STE 105
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-1275
Practice Address - Country:US
Practice Address - Phone:813-989-0861
Practice Address - Fax:813-464-7645
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA33158225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA33158OtherSTAE OF FLORIDA MASSAGE THERAPIST LICENSE