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General NPI Number Information
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NPI Number | 1922503770
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Entity Type | Individual
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Provider Name | CLARENCE ORVILLE MORRIS
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Gender | Male
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 03/26/2018
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Provider Practice Location Address
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Address Line | 3485 BESTLAND RD
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City | DUNNSVILLE
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State | VA
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Zip | 22454-2307
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Country | US
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Telephone | 804-238-4161
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Fax | 804-237-0492
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Provider Business Mailing Address
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Address Line | 3485 BESTLAND RD
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City | DUNNSVILLE
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State | VA
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Zip | 22454-2307
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Country | US
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Telephone | 804-238-4161
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Fax | 804-237-0492
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number | 26498
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License Number State | VA
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