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General NPI Number Information
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NPI Number | 1336406412
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Entity Type | Individual
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Provider Name | KENNETH DERAN MORGAN LPTA
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Gender | Male
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Dates
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Enumeration Date | 04/13/2012
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Last Update Date | 04/13/2012
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Provider Practice Location Address
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Address Line | 1720 S BELLAIRE ST STE 325
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City | DENVER
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State | CO
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Zip | 80222-4304
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Country | US
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Telephone | 866-801-9492
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Fax | 866-239-4719
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Provider Business Mailing Address
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Address Line | 222 GAYLE LN
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City | SATSUMA
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State | AL
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Zip | 36572-2310
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Country | US
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Telephone | 251-455-0839
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA4331
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License Number State | AL
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