Healthcare Provider Details

I. General information

NPI: 1699003475
Provider Name (Legal Business Name): ASHLEE MORSE ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2009
Last Update Date: 01/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3313 W HILLSBORO BLVD SUITE 202
DEERFIELD BEACH FL
33442-9423
US

IV. Provider business mailing address

124 LAKE MONTEREY CIR
BOYNTON BEACH FL
33426-8435
US

V. Phone/Fax

Practice location:
  • Phone: 561-955-4298
  • Fax:
Mailing address:
  • Phone: 704-519-5576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAL2596
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: