Provider Demographics
NPI:1245669019
Name:MORRISON, BRENDAN ALEXANDER (ATC/L)
Entity type:Individual
Prefix:
First Name:BRENDAN
Middle Name:ALEXANDER
Last Name:MORRISON
Suffix:
Gender:M
Credentials:ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 TITAN WAY
Mailing Address - Street 2:ATHLETIC TRAINER
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-8379
Mailing Address - Country:US
Mailing Address - Phone:239-377-9196
Mailing Address - Fax:239-377-1703
Practice Address - Street 1:2925 TITAN WAY
Practice Address - Street 2:ATHLETIC TRAINER
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-8379
Practice Address - Country:US
Practice Address - Phone:239-377-9196
Practice Address - Fax:239-377-1703
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-02
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL 42782255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer