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General NPI Number Information
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NPI Number | 1720548043
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Entity Type | Organization
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Legal Business Name | MORGAN CHIROPRACTIC PC
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Dates
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Enumeration Date | 03/22/2019
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Last Update Date | 03/22/2019
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Provider Practice Location Address
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Address Line | 811 VILLAGE WOOD DR
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City | RUSSELLVILLE
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State | AL
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Zip | 35654-8398
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Country | US
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Telephone | 256-332-4949
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Fax | 256-332-4943
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Provider Business Mailing Address
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Address Line | PO BOX 30
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City | RUSSELLVILLE
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State | AL
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Zip | 35653-0030
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Country | US
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Telephone | 256-332-6182
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Fax | 256-332-4943
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TOM MORGAN
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Credential | DC
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Telephone | 256-332-6182
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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 |
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License Number State |
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