Provider Demographics
NPI:1558191627
Name:LOCKLEAR, MORGAN (ATC)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:LOCKLEAR
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:
Other - Last Name:DORSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3116 TROY AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45213-1320
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 GREENDEVIL LN
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:KY
Practice Address - Zip Code:41074-1200
Practice Address - Country:US
Practice Address - Phone:859-292-7486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAT11272255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer