Healthcare Provider Details

I. General information

NPI: 1912972696
Provider Name (Legal Business Name): KRISTY MICHELLE MORGAN D.C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 08/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12409 W INDIAN SCHOOL RD STE B210
AVONDALE AZ
85392-9505
US

IV. Provider business mailing address

PO BOX 2954
PHOENIX AZ
85062-2954
US

V. Phone/Fax

Practice location:
  • Phone: 623-935-9920
  • Fax: 623-935-9925
Mailing address:
  • Phone: 602-889-5833
  • Fax: 602-889-5834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC009240
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number8050
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number4707
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: