=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023004769
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PAUL ERIC MORROW D.C.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/27/2005
-----------------------------------------------------
Last Update Date | 09/23/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1399 HASLETT RD
-----------------------------------------------------
City | HASLETT
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48840-8993
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-339-1304
-----------------------------------------------------
Fax | 517-339-1305
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1399 HASLETT RD P.O. BOX 450
-----------------------------------------------------
City | HASLETT
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48840-8993
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-339-1304
-----------------------------------------------------
Fax | 517-339-1305
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 2301005041
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 111NS0005X
-----------------------------------------------------
Taxonomy Name | Sports Physician Chiropractor
-----------------------------------------------------
License Number | 2301005041
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------