Healthcare Provider Details

I. General information

NPI: 1164193991
Provider Name (Legal Business Name): MORGAN KRUG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2021
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4822 E PALMETTO ST
FLORENCE SC
29506-4530
US

IV. Provider business mailing address

2439 WILLWOOD DR
FLORENCE SC
29501-3904
US

V. Phone/Fax

Practice location:
  • Phone: 814-512-8337
  • Fax:
Mailing address:
  • Phone: 814-512-8337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT03226
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: