Provider Demographics
NPI: | 1568867091 |
---|---|
Name: | MORRISON CHIROPRACTIC LLC |
Entity type: | Organization |
Organization Name: | MORRISON CHIROPRACTIC LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | ERIC |
Authorized Official - Middle Name: | J |
Authorized Official - Last Name: | MORRISON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DC |
Authorized Official - Phone: | 724-452-3929 |
Mailing Address - Street 1: | 516 PERRY WAY |
Mailing Address - Street 2: | |
Mailing Address - City: | ZELIENOPLE |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 16063-1504 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 724-452-3929 |
Mailing Address - Fax: | 888-811-2753 |
Practice Address - Street 1: | 516 PERRY WAY |
Practice Address - Street 2: | |
Practice Address - City: | ZELIENOPLE |
Practice Address - State: | PA |
Practice Address - Zip Code: | 16063-1504 |
Practice Address - Country: | US |
Practice Address - Phone: | 724-452-3929 |
Practice Address - Fax: | 888-811-2753 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2014-10-27 |
Last Update Date: | 2014-10-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PA | DC010271 | 111N00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 111N00000X | Chiropractic Providers | Chiropractor | Group - Single Specialty |