Provider Demographics
NPI:1992231955
Name:MORRISON, CARRIE JUNE (ATC, LAT)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:JUNE
Last Name:MORRISON
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:JUNE
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC, LAT
Mailing Address - Street 1:1304 BRYANT ST
Mailing Address - Street 2:
Mailing Address - City:BENBROOK
Mailing Address - State:TX
Mailing Address - Zip Code:76126-3451
Mailing Address - Country:US
Mailing Address - Phone:352-870-4005
Mailing Address - Fax:
Practice Address - Street 1:7500 DUTCH BRANCH RD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-4110
Practice Address - Country:US
Practice Address - Phone:817-321-0173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT43672255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer