Healthcare Provider Details

I. General information

NPI: 1952684409
Provider Name (Legal Business Name): MORGAN CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2011
Last Update Date: 09/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15255 HIGHWAY 43 STE 3
RUSSELLVILLE AL
35653-1925
US

IV. Provider business mailing address

15255 HIGHWAY 43 STE 3
RUSSELLVILLE AL
35653-1925
US

V. Phone/Fax

Practice location:
  • Phone: 256-332-4949
  • Fax: 256-332-4943
Mailing address:
  • Phone: 256-332-4949
  • Fax: 256-332-4943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1669
License Number StateAL

VIII. Authorized Official

Name: DR. TOM MORGAN
Title or Position: DC
Credential:
Phone: 256-332-4949