Provider Demographics
NPI:1689246993
Name:MORRIS, KATIE LEIGH (ATC)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:LEIGH
Last Name:MORRIS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 LANE ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2099
Mailing Address - Country:US
Mailing Address - Phone:859-228-0501
Mailing Address - Fax:
Practice Address - Street 1:1050 LANE ALLEN RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2099
Practice Address - Country:US
Practice Address - Phone:859-228-0501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY575672255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer