MEDICARE: RACHIEL MORRISON

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	347C00000X	Private Vehicle	195189	NC

General Provider Information

NPI Number	:	1821410903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHIEL MORRISON

Provider Business Mailing Address
First Line	:	3338 BARFIELD DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28217-1108
Country	:	US
Telephone Number	:	704-492-6289
Fax Number	:

Provider Business Practice Location Address
First Line	:	3338 BARFIELD DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28217-1108
Country	:	US
Telephone Number	:	704-492-6289
Fax Number	:

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

Provider Enumeration Date	:	01/09/2014
Last Update Date	:	01/09/2014

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