Provider Demographics
NPI:1568669968
Name:CRAIG E MORRIS D C A PROF CHIROPRACTIC CORP TORRANCE CHIROPRACTIC
Entity Type:Organization
Organization Name:CRAIG E MORRIS D C A PROF CHIROPRACTIC CORP TORRANCE CHIROPRACTIC
Other - Org Name:F.I.R.S.T. HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANIELLA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:310-793-9400
Mailing Address - Street 1:19000 HAWTHORNE BLVD
Mailing Address - Street 2:STE 302
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-1517
Mailing Address - Country:US
Mailing Address - Phone:310-793-9400
Mailing Address - Fax:310-793-0200
Practice Address - Street 1:19000 HAWTHORNE BLVD
Practice Address - Street 2:STE 302
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-1517
Practice Address - Country:US
Practice Address - Phone:310-793-9400
Practice Address - Fax:310-793-0200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC14700111NR0400X
CAPT5463225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWDC 14700AMedicare PIN
CAW14593Medicare ID - Type UnspecifiedCORPORATION