Healthcare Provider Details

I. General information

NPI: 1932314663
Provider Name (Legal Business Name): RITA DOROTHY MORGAN RTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

982 EASTERN PARKWAY
LOUISVILLE KY
40217
US

IV. Provider business mailing address

187 WILKERSON DRIVE
MT WASHINGTON KY
40047
US

V. Phone/Fax

Practice location:
  • Phone: 502-595-4459
  • Fax: 502-595-4673
Mailing address:
  • Phone: 502-538-6631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number10-056-00973 (ARRT)
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: