Provider Demographics
NPI:1679926117
Name:MORRISSEY, WILLIAM DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DAVID
Last Name:MORRISSEY
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 1:101 LIVINGSTON LOOP STE C4
Mailing Address - Street 2:
Mailing Address - City:SANTA TERESA
Mailing Address - State:NM
Mailing Address - Zip Code:88008-9753
Mailing Address - Country:US
Mailing Address - Phone:915-833-7797
Mailing Address - Fax:915-833-7239
Practice Address - Street 1:101 LIVINGSTON LOOP STE C4
Practice Address - Street 2:
Practice Address - City:SANTA TERESA
Practice Address - State:NM
Practice Address - Zip Code:88008-9753
Practice Address - Country:US
Practice Address - Phone:915-833-7797
Practice Address - Fax:915-833-7239
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2153111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor