Provider Demographics
NPI:1780025486
Name:MORRISON, DANIEL (ATC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:MORRISON
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 ANDREW AVE
Mailing Address - Street 2:422
Mailing Address - City:LA PORTE
Mailing Address - State:IN
Mailing Address - Zip Code:46350-6543
Mailing Address - Country:US
Mailing Address - Phone:616-915-6652
Mailing Address - Fax:
Practice Address - Street 1:2400 ANDREW AVE
Practice Address - Street 2:422
Practice Address - City:LA PORTE
Practice Address - State:IN
Practice Address - Zip Code:46350-6543
Practice Address - Country:US
Practice Address - Phone:616-915-6652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-10
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260015232255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer