Provider Demographics
NPI:1235342007
Name:BAGLEY, MORGAN COOPER (ATC)
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:COOPER
Last Name:BAGLEY
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:LYNN
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:1972 CLARK AVE
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601
Mailing Address - Country:US
Mailing Address - Phone:330-829-8962
Mailing Address - Fax:330-823-4896
Practice Address - Street 1:1972 CLARK AVE
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601
Practice Address - Country:US
Practice Address - Phone:330-829-8962
Practice Address - Fax:330-823-4896
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11622255A2300X
OHAT0023532255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer