Provider Demographics
NPI:1568021376
Name:MORRIS, TERRY B (RPH)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:B
Last Name:MORRIS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16933 256TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPIRIT LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:51360-6877
Mailing Address - Country:US
Mailing Address - Phone:712-261-0474
Mailing Address - Fax:888-859-1765
Practice Address - Street 1:127 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PAULLINA
Practice Address - State:IA
Practice Address - Zip Code:51046-7758
Practice Address - Country:US
Practice Address - Phone:712-949-3490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA14953183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1801228556OtherNPI