=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053065441
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RACHEL MOORMAN MORRIS ATC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/05/2022
-----------------------------------------------------
Last Update Date | 03/17/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 900 ARKADELPHIA ROAD
-----------------------------------------------------
City | BIRMINGHAM
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35254-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-226-4946
-----------------------------------------------------
Fax | 205-226-3067
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9410 BROOK FOREST CIR
-----------------------------------------------------
City | HELENA
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35080-3455
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-468-3176
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2255A2300X
-----------------------------------------------------
Taxonomy Name | Athletic Trainer
-----------------------------------------------------
License Number | 1259
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------