Provider Demographics
NPI:1285783530
Name:MORGAN, DAVID W (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:MORGAN
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 1:570 SE BENEWAH ST TRLR 122
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163-6416
Mailing Address - Country:US
Mailing Address - Phone:509-334-0520
Mailing Address - Fax:
Practice Address - Street 1:102 S WASHINGTON
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:ID
Practice Address - Zip Code:83843-2842
Practice Address - Country:US
Practice Address - Phone:208-882-3012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-553111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor