Provider Demographics
NPI:1639133549
Name:MORRIS, SUSAN DELEAN (DC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:DELEAN
Last Name:MORRIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 ARMORY ST
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-5421
Mailing Address - Country:US
Mailing Address - Phone:843-332-4672
Mailing Address - Fax:843-332-0798
Practice Address - Street 1:107 ARMORY ST
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-5421
Practice Address - Country:US
Practice Address - Phone:843-332-4672
Practice Address - Fax:843-332-0798
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-17
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2942111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCV03323Medicare UPIN
SCAA07500281Medicare PIN