Provider Demographics
NPI:1063545663
Name:MORGAN, JOHNNIE LEWIS JR (DC)
Entity type:Individual
Prefix:DR
First Name:JOHNNIE
Middle Name:LEWIS
Last Name:MORGAN
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 N MAIN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84721-1230
Mailing Address - Country:US
Mailing Address - Phone:435-260-7005
Mailing Address - Fax:
Practice Address - Street 1:1320 N MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84721-1230
Practice Address - Country:US
Practice Address - Phone:435-260-7005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002412A111N00000X
AL2210111N00000X
GACHIRO08163111N00000X
UT9136593-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor