Provider Demographics
NPI:1346639093
Name:AUSTGEN, MORGAN ANN (ATC)
Entity Type:Individual
Prefix:MS
First Name:MORGAN
Middle Name:ANN
Last Name:AUSTGEN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:208 W SAGINAW ST
Mailing Address - Street 2:APT. 208
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-2658
Mailing Address - Country:US
Mailing Address - Phone:219-306-0278
Mailing Address - Fax:
Practice Address - Street 1:223 KALAMAZOO ST
Practice Address - Street 2:JENISON FIELD HOUSE ATHLETIC TRAINING ROOM 106
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824-5400
Practice Address - Country:US
Practice Address - Phone:517-355-1627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-19
Last Update Date:2015-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI26010013282255R0406X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255R0406XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistRehabilitation, Blind
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI22OtherRESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS
MI2255A2300XOtherATHLETIC TRAINER