Provider Demographics
NPI:1366771511
Name:JON MORRIS CHIROPRACTIC, A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:JON MORRIS CHIROPRACTIC, A PROFESSIONAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:R
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:661-246-4026
Mailing Address - Street 1:4312 LITTLER CT
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-7548
Mailing Address - Country:US
Mailing Address - Phone:661-246-4026
Mailing Address - Fax:
Practice Address - Street 1:2100 19TH ST STE C
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3719
Practice Address - Country:US
Practice Address - Phone:661-246-4026
Practice Address - Fax:661-246-4020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-17
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19223111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU05553Medicare UPIN