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General NPI Number Information
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NPI Number | 1992231955
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Entity Type | Individual
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Provider Name | CARRIE JUNE MORRISON ATC, LAT
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Gender | Female
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 7500 DUTCH BRANCH RD
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City | FORT WORTH
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State | TX
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Zip | 76132-4110
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Country | US
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Telephone | 817-321-0173
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Fax |
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Provider Business Mailing Address
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Address Line | 1304 BRYANT ST
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City | BENBROOK
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State | TX
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Zip | 76126-3451
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Country | US
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Telephone | 352-870-4005
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT4367
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License Number State | TX
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