Provider Demographics
NPI:1326499351
Name:MORSE, CHRISTOPHER LINCOLN (ATC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:LINCOLN
Last Name:MORSE
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3
Mailing Address - Street 2:
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63902-0003
Mailing Address - Country:US
Mailing Address - Phone:573-712-2280
Mailing Address - Fax:
Practice Address - Street 1:3999 HIGHWAY PP STE 2
Practice Address - Street 2:
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-9130
Practice Address - Country:US
Practice Address - Phone:573-712-2280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20000255932255A2300X
MO2020022918225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer