Healthcare Provider Details

I. General information

NPI: 1417148750
Provider Name (Legal Business Name): MORAN HEALTH SYSTEM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2007
Last Update Date: 04/01/2022
Certification Date: 04/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3639 CASS RD
TRAVERSE CITY MI
49684-9153
US

IV. Provider business mailing address

3639 CASS RD
TRAVERSE CITY MI
49684-9153
US

V. Phone/Fax

Practice location:
  • Phone: 231-943-2100
  • Fax: 231-766-6161
Mailing address:
  • Phone: 231-943-2100
  • Fax: 231-766-6161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number2301006134
License Number StateMI

VIII. Authorized Official

Name: DR. CHRISTOPER MORAN
Title or Position: OWNER
Credential: DC
Phone: 231-943-2100