Healthcare Provider Details

I. General information

NPI: 1952325888
Provider Name (Legal Business Name): LAWRENCE C MORRIS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 12/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

536 KINGSLEY AVE STE 129
ORANGE PARK FL
32073
US

IV. Provider business mailing address

1585 SANTA BARBARA BLVD STE A
THE VILLAGES FL
32159-6820
US

V. Phone/Fax

Practice location:
  • Phone: 904-278-7246
  • Fax: 904-278-8871
Mailing address:
  • Phone: 352-430-2121
  • Fax: 352-430-2121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH4992
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: