Provider Demographics
NPI:1811186372
Name:MORACK CHIROPRACTIC CENTER, P.C.
Entity Type:Organization
Organization Name:MORACK CHIROPRACTIC CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:MORACK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-252-0800
Mailing Address - Street 1:4014A S LYNN CT DR
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-3360
Mailing Address - Country:US
Mailing Address - Phone:816-252-0800
Mailing Address - Fax:816-252-1055
Practice Address - Street 1:4014A S LYNN CT DR
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-3360
Practice Address - Country:US
Practice Address - Phone:816-252-0800
Practice Address - Fax:816-252-1055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006665261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
1235197831OtherINDIVIDUAL NPI
KSP500383Medicare UPIN
1235197831OtherINDIVIDUAL NPI