Healthcare Provider Details
I. General information
NPI: 1912205006
Provider Name (Legal Business Name): MORGAN'S FAMILY CHIROPRACTIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/14/2011
Last Update Date: 03/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
151 N STATE ST
MORGAN UT
84050-9919
US
IV. Provider business mailing address
PO BOX 135
MORGAN UT
84050-0135
US
V. Phone/Fax
- Phone: 801-845-8156
- Fax:
- Phone: 801-845-8156
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 7443715-1202 |
| License Number State | UT |
VIII. Authorized Official
Name: DR.
RYAN
E
EVERHART
Title or Position: OWNER
Credential: D.C.
Phone: 801-845-8156