Provider Demographics
NPI:1861668352
Name:MORICI CHIROPRACTIC P C
Entity Type:Organization
Organization Name:MORICI CHIROPRACTIC P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:PHILLIP
Authorized Official - Last Name:MORICI
Authorized Official - Suffix:
Authorized Official - Credentials:PC
Authorized Official - Phone:586-997-2441
Mailing Address - Street 1:43200 DEQUINDRE RD STE 109
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-1707
Mailing Address - Country:US
Mailing Address - Phone:586-997-2441
Mailing Address - Fax:586-997-2506
Practice Address - Street 1:43200 DEQUINDRE RD STE 109
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-1707
Practice Address - Country:US
Practice Address - Phone:586-997-2441
Practice Address - Fax:586-997-2506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301006126111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty