Provider Demographics
NPI:1962586107
Name:MORGAN, DALE ARTHUR (DC)
Entity type:Individual
Prefix:
First Name:DALE
Middle Name:ARTHUR
Last Name:MORGAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1324 W AUBURN RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-4386
Mailing Address - Country:US
Mailing Address - Phone:248-299-4447
Mailing Address - Fax:248-299-1816
Practice Address - Street 1:1324 W AUBURN RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-4386
Practice Address - Country:US
Practice Address - Phone:248-299-4447
Practice Address - Fax:248-299-1816
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004918111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M90450Medicare PIN
U23005Medicare UPIN