Provider Demographics
NPI:1376036939
Name:MORRISON, TRISTAN PRESCOTT (ATC)
Entity type:Individual
Prefix:
First Name:TRISTAN
Middle Name:PRESCOTT
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 1:530A LAKE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-4956
Mailing Address - Country:US
Mailing Address - Phone:910-381-1999
Mailing Address - Fax:
Practice Address - Street 1:530A LAKE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-4956
Practice Address - Country:US
Practice Address - Phone:910-381-1999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-08
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer