Provider Demographics
NPI:1396297008
Name:MORRISON, RYAN (ATC)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:MORRISON
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4821 DUVERNAY DR APT 103
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-8233
Mailing Address - Country:US
Mailing Address - Phone:734-417-6782
Mailing Address - Fax:
Practice Address - Street 1:4821 DUVERNAY DR APT 103
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-8233
Practice Address - Country:US
Practice Address - Phone:734-417-6782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-28
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer