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General NPI Number Information
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NPI Number | 1710084090
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Entity Type | Organization
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Legal Business Name | MORLOCK CHIROPRACTIC CENTER
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1602 30TH AVE S
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City | MOORHEAD
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State | MN
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Zip | 56560-5152
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Country | US
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Telephone | 218-233-4402
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Fax | 218-233-1026
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Provider Business Mailing Address
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Address Line | 1602 30TH AVE S
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City | MOORHEAD
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State | MN
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Zip | 56560-5152
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Country | US
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Telephone | 218-233-4402
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Fax | 218-233-1026
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Authorized Official
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Title or Position | OWNER
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Name | DR. GREGG MORLOCK
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Credential | D.C.
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Telephone | 218-233-4402
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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 | 1760
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License Number State | MN
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