Provider Demographics
NPI:1427400605
Name:SCALLEN, MORGAN CONLON
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:CONLON
Last Name:SCALLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5494 ST. CLAIR HWY.
Mailing Address - Street 2:
Mailing Address - City:CHINA TWP.
Mailing Address - State:MI
Mailing Address - Zip Code:48054
Mailing Address - Country:US
Mailing Address - Phone:810-278-1655
Mailing Address - Fax:
Practice Address - Street 1:5494 ST. CLAIR HWY.
Practice Address - Street 2:
Practice Address - City:CHINA TWP.
Practice Address - State:MI
Practice Address - Zip Code:48054
Practice Address - Country:US
Practice Address - Phone:810-278-1655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other