Provider Demographics
NPI:1164768123
Name:J.C. MORRIS, DC,PC
Entity Type:Organization
Organization Name:J.C. MORRIS, DC,PC
Other - Org Name:ACTIVE LIVING CHIROPRACTIC AND REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:1541-389-5232
Mailing Address - Street 1:142 NW HAWTHORNE AVE
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-2918
Mailing Address - Country:US
Mailing Address - Phone:541-389-5232
Mailing Address - Fax:541-385-0140
Practice Address - Street 1:142 NW HAWTHORNE AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-2918
Practice Address - Country:US
Practice Address - Phone:541-389-5232
Practice Address - Fax:541-385-0140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-19
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3702261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care