Provider Demographics
NPI:1043352834
Name:MORI, ALAN ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:ROBERT
Last Name:MORI
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 1:7886 WINCHESTER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-2397
Mailing Address - Country:US
Mailing Address - Phone:901-757-8311
Mailing Address - Fax:901-752-0304
Practice Address - Street 1:7886 WINCHESTER RD STE 101
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-2397
Practice Address - Country:US
Practice Address - Phone:901-757-8311
Practice Address - Fax:901-752-0304
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2001111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNV03326Medicare UPIN