Provider Demographics
NPI:1639637150
Name:BURY, MORGAN (DC)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:BURY
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 1:1704 N DIXIE AVE STE E7
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-3428
Mailing Address - Country:US
Mailing Address - Phone:270-219-2186
Mailing Address - Fax:
Practice Address - Street 1:1704 N DIXIE AVE STE E7
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-3428
Practice Address - Country:US
Practice Address - Phone:270-219-2186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5580111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor