Provider Demographics
NPI:1225593221
Name:MORLEY, ROBERT EDWIN (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:EDWIN
Last Name:MORLEY
Suffix:
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 1:10590 COUNTRY WALK DR UNIT 2
Mailing Address - Street 2:
Mailing Address - City:SISTER BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54234-9103
Mailing Address - Country:US
Mailing Address - Phone:920-633-4055
Mailing Address - Fax:
Practice Address - Street 1:10590 COUNTRY WALK DR UNIT 2
Practice Address - Street 2:
Practice Address - City:SISTER BAY
Practice Address - State:WI
Practice Address - Zip Code:54234-9103
Practice Address - Country:US
Practice Address - Phone:920-633-4055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-04
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5422-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor