Provider Demographics
NPI:1174860332
Name:CAMPBELL, RITASUE MORGAN (MS, ATC, LAT)
Entity Type:Individual
Prefix:
First Name:RITASUE
Middle Name:MORGAN
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 NW CARLSON RD
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66615-9662
Mailing Address - Country:US
Mailing Address - Phone:661-900-2582
Mailing Address - Fax:
Practice Address - Street 1:1520 NW CARLSON RD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66615-9662
Practice Address - Country:US
Practice Address - Phone:661-900-2582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24005662255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer