=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235542580
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MORRISON CHIROPRACTIC LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/04/2014
-----------------------------------------------------
Last Update Date | 06/06/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 131 N 6TH AVE
-----------------------------------------------------
City | STERLING
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80751
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-521-7200
-----------------------------------------------------
Fax | 970-521-7201
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 131 N 6TH AVE
-----------------------------------------------------
City | STERLING
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80751-2901
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-521-7200
-----------------------------------------------------
Fax | 970-521-7201
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | KRIS MORRISON
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 970-521-7200
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | CHR.0005510
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------