Provider Demographics
NPI:1417715137
Name:ATKINS, MORGAN (LPTA)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:ATKINS
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:DANIELLE
Other - Last Name:BUCKLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:139 WALNUT RD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:VA
Mailing Address - Zip Code:24136-3185
Mailing Address - Country:US
Mailing Address - Phone:540-599-1912
Mailing Address - Fax:
Practice Address - Street 1:1009 OLD COUNTRY CLUB RD NW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24017-2927
Practice Address - Country:US
Practice Address - Phone:540-676-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306603658225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant