Provider Demographics
NPI:1437412624
Name:MORGAN CHIROPRACTIC
Entity Type:Organization
Organization Name:MORGAN CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:WILBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-583-0900
Mailing Address - Street 1:2010 S 1000 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-3321
Mailing Address - Country:US
Mailing Address - Phone:801-583-0900
Mailing Address - Fax:801-582-7823
Practice Address - Street 1:2010 S 1000 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84105-3321
Practice Address - Country:US
Practice Address - Phone:801-583-0900
Practice Address - Fax:801-582-7823
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR. KEVIN MORGAN D.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT172708-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty