Individual
RUSSELL CHARLES MORGAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC/L
Contact information
Practice address
5510 E STATE ST, ROCKFORD, IL 61108-2381
(815) 395-4505
Mailing address
6405 1ST ST, LOVES PARK, IL 61111-4103
(815) 633-2348
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
03/14/2006
Last updated
07/08/2007
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