Provider Demographics
NPI:1831141340
Name:MORRIS, CHARLES J (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:J
Last Name:MORRIS
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 1:13002 SEMINOLE BLVD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33778-2125
Mailing Address - Country:US
Mailing Address - Phone:727-585-8888
Mailing Address - Fax:
Practice Address - Street 1:13002 SEMINOLE BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33778-2125
Practice Address - Country:US
Practice Address - Phone:727-585-8888
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5362111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL70940OtherBCBS OF FLORIDA
FL70940Medicare ID - Type Unspecified