Provider Demographics
NPI:1649623778
Name:MORSE, RICHARD KEENAN (LAT, ATC, EMT)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:KEENAN
Last Name:MORSE
Suffix:
Gender:M
Credentials:LAT, ATC, EMT
Other - Prefix:
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Mailing Address - Street 1:338 DOGWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:RADCLIFF
Mailing Address - State:KY
Mailing Address - Zip Code:40160-9750
Mailing Address - Country:US
Mailing Address - Phone:270-872-9072
Mailing Address - Fax:
Practice Address - Street 1:1111 RING RD
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-4900
Practice Address - Country:US
Practice Address - Phone:270-734-1810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-13
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KYTCA4482255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer