Provider Demographics
NPI:1407364755
Name:LIGHTSEY-SANTOS, MORGAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:
Last Name:LIGHTSEY-SANTOS
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 1:17287 US HIGHWAY 331 S
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:FL
Mailing Address - Zip Code:32439-4206
Mailing Address - Country:US
Mailing Address - Phone:850-312-9573
Mailing Address - Fax:
Practice Address - Street 1:17287 US HIGHWAY 331 S
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:FL
Practice Address - Zip Code:32439-4206
Practice Address - Country:US
Practice Address - Phone:850-312-9573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-19
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12326111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor