Healthcare Provider Details

I. General information

NPI: 1639262165
Provider Name (Legal Business Name): MICHAEL PERRY MORRIS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 05/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11518 E APACHE TRL 119
APACHE JUNCTION AZ
85120-3551
US

IV. Provider business mailing address

1052 E NAVAJO AVE
APACHE JUNCTION AZ
85119-7769
US

V. Phone/Fax

Practice location:
  • Phone: 480-357-3695
  • Fax: 480-357-3698
Mailing address:
  • Phone: 480-671-4780
  • Fax: 480-357-3698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7184
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: