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General NPI Number Information
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NPI Number | 1669581468
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Entity Type | Organization
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Legal Business Name | MORRIS FAMILY CHIROPRACTIC PA
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 09/24/2007
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Provider Practice Location Address
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Address Line | 1332 SUNSET DRIVE SUITE A
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City | GRENADA
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State | MS
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Zip | 38901-4000
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Country | US
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Telephone | 662-229-0690
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Fax | 662-229-0352
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Provider Business Mailing Address
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Address Line | 1332 SUNSET DRIVE SUITE A
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City | GRENADA
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State | MS
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Zip | 38901-4000
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Country | US
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Telephone | 662-229-0690
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Fax | 662-229-0352
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | JOHNNIE E. MORRIS
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Credential | DC
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Telephone | 662-229-0690
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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 | 0995
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License Number State | MS
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