Provider Demographics
NPI:1689136517
Name:MORRIS, KYLE (LAT, ATC, OTC, OT-SC)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:MORRIS
Suffix:
Gender:M
Credentials:LAT, ATC, OTC, OT-SC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6335 HOSPITAL PKWY STE 400
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-5809
Mailing Address - Country:US
Mailing Address - Phone:404-778-3350
Mailing Address - Fax:404-778-0847
Practice Address - Street 1:6335 HOSPITAL PKWY STE 400
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-5809
Practice Address - Country:US
Practice Address - Phone:404-778-3350
Practice Address - Fax:404-778-0847
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246ZC0007X
NY0037482255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant