Healthcare Provider Details

I. General information

NPI: 1609595651
Provider Name (Legal Business Name): MORGAN FERENCE MS, LAT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2022
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E VETERAN'S WAY
TEMPE AZ
85287-0001
US

IV. Provider business mailing address

500 E VETERAN'S WAY
TEMPE AZ
85287-0001
US

V. Phone/Fax

Practice location:
  • Phone: 757-375-4769
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: