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General NPI Number Information
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NPI Number | 1508343914
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Entity Type | Organization
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Legal Business Name | MORGANICS, LLC
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Dates
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Enumeration Date | 07/27/2018
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Last Update Date | 07/27/2018
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Provider Practice Location Address
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Address Line | 213 CREEKSIDE OFFICE DR
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City | WENTZVILLE
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State | MO
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Zip | 63385-3290
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Country | US
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Telephone | 636-614-4600
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Fax | 844-892-4533
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Provider Business Mailing Address
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Address Line | 9 ROBINSON RD
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City | TROY
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State | MO
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Zip | 63379-5109
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Country | US
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Telephone | 209-658-9995
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Fax | 844-892-4533
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL GREGORY LYELL
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Credential | DC
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Telephone | 209-658-9995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2017018593
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License Number State | MO
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