Provider Demographics
NPI:1558451922
Name:MORRISON, MARK C (DC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:C
Last Name:MORRISON
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 1:3629 FAIRMOUNT ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-4710
Mailing Address - Country:US
Mailing Address - Phone:214-415-2830
Mailing Address - Fax:214-522-8619
Practice Address - Street 1:3629 FAIRMOUNT ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-4710
Practice Address - Country:US
Practice Address - Phone:214-415-2830
Practice Address - Fax:214-522-8619
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8162111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor