Provider Demographics
NPI:1568894657
Name:MORTER, JOSHUA BRINK (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:BRINK
Last Name:MORTER
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:PO BOX 11464
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-0030
Mailing Address - Country:US
Mailing Address - Phone:615-900-3770
Mailing Address - Fax:
Practice Address - Street 1:2445 MEMORIAL BLVD H
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-5156
Practice Address - Country:US
Practice Address - Phone:615-900-3770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2685111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor