Provider Demographics
NPI:1255483889
Name:MORRIS, MICHAEL JAIME (DC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JAIME
Last Name:MORRIS
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:PO BOX 1911
Mailing Address - Street 2:
Mailing Address - City:HIGLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85236-1911
Mailing Address - Country:US
Mailing Address - Phone:480-345-6453
Mailing Address - Fax:480-756-2530
Practice Address - Street 1:1761 E WARNER RD STE A17
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-4558
Practice Address - Country:US
Practice Address - Phone:480-345-6453
Practice Address - Fax:480-756-2530
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5990111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor