Healthcare Provider Details

I. General information

NPI: 1134651458
Provider Name (Legal Business Name): STEPHANIE MORGAN MAT, LAT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: STEPHANIE RYCHLEC MAT, LAT, ATC

II. Dates (important events)

Enumeration Date: 03/28/2017
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FORT CARSON
APO AA
80913
US

IV. Provider business mailing address

6287 SAN MATEO DR
COLORADO SPRINGS CO
80911-4008
US

V. Phone/Fax

Practice location:
  • Phone: 303-906-8069
  • Fax:
Mailing address:
  • Phone: 303-906-8069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT8940
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT.0001808
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: