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General NPI Number Information
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NPI Number | 1932312360
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Entity Type | Organization
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Legal Business Name | MORGAN CHIROPRACTIC P C
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 03/08/2012
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Provider Practice Location Address
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Address Line | 4807 SHORE DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-2714
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Country | US
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Telephone | 757-498-8455
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Fax |
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Provider Business Mailing Address
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Address Line | 4604 LAKE DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-1415
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Country | US
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Telephone | 757-222-9462
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS JACKSON MORGAN JR.
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Credential | D.C.
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Telephone | 757-498-8455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 0104001216
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License Number State | VA
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