Provider Demographics
NPI:1588018675
Name:MORGAN, JEREMIAH (DC)
Entity type:Individual
Prefix:DR
First Name:JEREMIAH
Middle Name:
Last Name:MORGAN
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 1:3512 MARY ELIZABETH CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-9272
Mailing Address - Country:US
Mailing Address - Phone:704-837-8557
Mailing Address - Fax:
Practice Address - Street 1:3512 MARY ELIZABETH CHURCH RD
Practice Address - Street 2:
Practice Address - City:WAXHAW
Practice Address - State:NC
Practice Address - Zip Code:28173-9272
Practice Address - Country:US
Practice Address - Phone:704-837-8557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-15
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4136111NR0400X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation