=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780785444
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE MORGAN CHIROPRACTIC CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/26/2006
-----------------------------------------------------
Last Update Date | 07/31/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1019 CHRISTIAN ST
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19147-3707
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-922-4782
-----------------------------------------------------
Fax | 215-440-7539
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1019 CHRISTIAN ST
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19147-3707
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-922-4782
-----------------------------------------------------
Fax | 215-440-7539
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIROPRACTIC
-----------------------------------------------------
Name | CORRINE MORGAN
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 215-922-4782
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC003397L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC008767L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC008051L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------