Provider Demographics
NPI:1619561099
Name:ATCHLEY, MORGAN (CST)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:ATCHLEY
Suffix:
Gender:F
Credentials:CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9005 E LEHIGH AVE APT 44
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-1931
Mailing Address - Country:US
Mailing Address - Phone:970-712-9381
Mailing Address - Fax:
Practice Address - Street 1:9005 E LEHIGH AVE APT 44
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-1931
Practice Address - Country:US
Practice Address - Phone:970-712-9381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO183762156F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO183762OtherNBSTSA