Individual
ELISABETH MORCOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
1000 E NARRAMORE AVE, BUCKEYE, AZ 85326-2632
(520) 405-7119
Mailing address
1000 E NARRAMORE AVE, BUCKEYE, AZ 85326-2632
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1416
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22
ATHLETIC TRAINER
—
Enumeration date
12/11/2017
Last updated
12/11/2017
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