Provider Demographics
NPI:1932265444
Name:MORRILL, CAROL (LAC)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:MORRILL
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33913 KLETTES PRIDE WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH FORK
Mailing Address - State:CA
Mailing Address - Zip Code:93643-9768
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:40214 ENTERPRISE DR.
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:CA
Practice Address - Zip Code:93644-8839
Practice Address - Country:US
Practice Address - Phone:559-760-0892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACU2931171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist