Provider Demographics
NPI:1508087818
Name:MORLEY CHIROPRACTIC PC
Entity Type:Organization
Organization Name:MORLEY CHIROPRACTIC PC
Other - Org Name:AHWATUKEE LIFE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:QUENTON
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:MORLEY
Authorized Official - Suffix:
Authorized Official - Credentials:BSC DC
Authorized Official - Phone:480-893-3437
Mailing Address - Street 1:4855 E WARNER RD
Mailing Address - Street 2:# A 23
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044
Mailing Address - Country:US
Mailing Address - Phone:480-893-3437
Mailing Address - Fax:480-893-9192
Practice Address - Street 1:4855 E WARNER RD
Practice Address - Street 2:# A 23
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044
Practice Address - Country:US
Practice Address - Phone:480-893-3437
Practice Address - Fax:480-893-9192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ04440111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0238680OtherDR MORLEY BCBS
23074440OtherDR MORLEY WORKERS COMP
04440OtherDR MORLEY MEDICAL LICENSE
1922063148OtherDR MORLEY NPI NUMBER
=========OtherEMPLOYERS TAX ID NUMBER
U47762Medicare UPIN
=========OtherEMPLOYERS TAX ID NUMBER