Healthcare Provider Details

I. General information

NPI: 1174601173
Provider Name (Legal Business Name): CASEY GEORGE MORRIS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 06/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 5TH AVENUE N
JACKSONVILLE BEACH FL
32250-5611
US

IV. Provider business mailing address

333 5TH AVENUE N
JACKSONVILLE BEACH FL
32250-5611
US

V. Phone/Fax

Practice location:
  • Phone: 904-241-7907
  • Fax: 904-241-1401
Mailing address:
  • Phone: 904-241-7907
  • Fax: 904-241-1401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH8378
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: