Provider Demographics
NPI:1912726381
Name:MORLAN SPINE AND SPORT LLC
Entity type:Organization
Organization Name:MORLAN SPINE AND SPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:COOPER
Authorized Official - Middle Name:
Authorized Official - Last Name:MORLAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:580-774-8231
Mailing Address - Street 1:1123 E DAVIS AVE
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-2230
Mailing Address - Country:US
Mailing Address - Phone:918-248-0948
Mailing Address - Fax:
Practice Address - Street 1:1123 E DAVIS AVE
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-2230
Practice Address - Country:US
Practice Address - Phone:918-248-0948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-03
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty