Provider Demographics
NPI:1073763587
Name:MORGAN, RICHARD WAYNE (LMT LAC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:WAYNE
Last Name:MORGAN
Suffix:
Gender:M
Credentials:LMT LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 SILVER CLOUD CIR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37821-6637
Mailing Address - Country:US
Mailing Address - Phone:423-608-1641
Mailing Address - Fax:
Practice Address - Street 1:159 SILVER CLOUD CIR
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-6637
Practice Address - Country:US
Practice Address - Phone:423-608-1641
Practice Address - Fax:423-623-8651
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-22
Last Update Date:2016-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN711225700000X
TNACU0000000086171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist