MEDICARE: DR. TANNER MORRIS DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	100143	IA

General Provider Information

NPI Number	:	1790311165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TANNER MORRIS DC

Provider Business Mailing Address
First Line	:	1411 E LAKESHORE DR
Second Line	:
City	:	STORM LAKE
State	:	IA
Zip	:	50588-2683
Country	:	US
Telephone Number	:	712-732-7280
Fax Number	:

Provider Business Practice Location Address
First Line	:	1411 E LAKESHORE DR
Second Line	:
City	:	STORM LAKE
State	:	IA
Zip	:	50588-2683
Country	:	US
Telephone Number	:	712-732-7280
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2020
Last Update Date	:	05/20/2020

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