Healthcare Provider Details

I. General information

NPI: 1811709603
Provider Name (Legal Business Name): VICTORIA ANGELISE MORALES DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/21/2025
Last Update Date: 01/21/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1309 PANORAMA DR STE 107
CHATTANOOGA TN
37421-4771
US

IV. Provider business mailing address

5133 CITY STATION DR APT 308
OOLTEWAH TN
37363-7245
US

V. Phone/Fax

Practice location:
  • Phone: 423-541-3771
  • Fax:
Mailing address:
  • Phone: 407-640-3763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3921
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number3921
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: