Healthcare Provider Details

I. General information

NPI: 1619910262
Provider Name (Legal Business Name): KEVIN ASHLEY MORRIS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 E MAIN ST STE A
KINGSTREE SC
29556-3512
US

IV. Provider business mailing address

722 NORTH FRASER STREET SUIT A
GEORGETOWN SC
29440
US

V. Phone/Fax

Practice location:
  • Phone: 843-355-5131
  • Fax: 843-355-5137
Mailing address:
  • Phone: 843-527-4200
  • Fax: 843-527-4222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2644
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: