Provider Demographics
NPI:1104830488
Name:MORRISON, CORINA LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:CORINA
Middle Name:LYNN
Last Name:MORRISON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72405 PARK VIEW DR STE A
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-3317
Mailing Address - Country:US
Mailing Address - Phone:760-340-1958
Mailing Address - Fax:760-340-2280
Practice Address - Street 1:72405 PARKVIEW DR STE A
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-2716
Practice Address - Country:US
Practice Address - Phone:760-340-1958
Practice Address - Fax:760-340-2280
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC025209111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0252090Medicare ID - Type Unspecified
CAP00145284Medicare UPIN