Provider Demographics
NPI:1396023776
Name:MORSE, COURTNEY LANE (DPT)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:LANE
Last Name:MORSE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11444 E CENTRAL AVE STE 1040
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-2805
Mailing Address - Country:US
Mailing Address - Phone:316-290-9158
Mailing Address - Fax:316-263-1241
Practice Address - Street 1:11444 E CENTRAL AVE STE 1040
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2805
Practice Address - Country:US
Practice Address - Phone:316-290-9158
Practice Address - Fax:316-263-1241
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-04311225100000X
KS1104311225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist