Provider Demographics
NPI:1942529433
Name:MORTER, KATRINA (DC)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:MORTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:
Other - Last Name:GEATTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3201 NE 11TH ST
Mailing Address - Street 2:SUITE 13
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-9131
Mailing Address - Country:US
Mailing Address - Phone:479-268-4477
Mailing Address - Fax:
Practice Address - Street 1:3201 NE 11TH ST
Practice Address - Street 2:SUITE 13
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-9131
Practice Address - Country:US
Practice Address - Phone:479-268-4477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3952111N00000X
IN08002524A111N00000X
AR15936111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor