Provider Demographics
NPI:1386162170
Name:LAPRADE, MORGAN LEE
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:LEE
Last Name:LAPRADE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 LORENZO DR
Mailing Address - Street 2:
Mailing Address - City:NORTH MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29582-6618
Mailing Address - Country:US
Mailing Address - Phone:434-221-7019
Mailing Address - Fax:
Practice Address - Street 1:908 LORENZO DR
Practice Address - Street 2:
Practice Address - City:NORTH MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29582-6618
Practice Address - Country:US
Practice Address - Phone:434-221-7019
Practice Address - Fax:434-221-7019
Is Sole Proprietor?:No
Enumeration Date:2017-09-01
Last Update Date:2017-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer