Provider Demographics
NPI:1932312360
Name:MORGAN CHIROPRACTIC P C
Entity Type:Organization
Organization Name:MORGAN CHIROPRACTIC P C
Other - Org Name:MORGAN WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JACKSON
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:757-498-8455
Mailing Address - Street 1:4604 LAKE DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-1415
Mailing Address - Country:US
Mailing Address - Phone:757-222-9462
Mailing Address - Fax:
Practice Address - Street 1:4807 SHORE DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-2714
Practice Address - Country:US
Practice Address - Phone:757-498-8455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001216111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAU-43212Medicare UPIN
VA350000938Medicare ID - Type Unspecified