Provider Demographics
NPI:1245372820
Name:MORRIS, PATRICK (DC)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
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 1:901 W WICKENBURG WAY
Mailing Address - Street 2:STE 5
Mailing Address - City:WICKENBURG
Mailing Address - State:AZ
Mailing Address - Zip Code:85390-4228
Mailing Address - Country:US
Mailing Address - Phone:928-684-3296
Mailing Address - Fax:928-684-3296
Practice Address - Street 1:901 W WICKENBURG WAY
Practice Address - Street 2:STE 5
Practice Address - City:WICKENBURG
Practice Address - State:AZ
Practice Address - Zip Code:85390-4228
Practice Address - Country:US
Practice Address - Phone:928-684-3296
Practice Address - Fax:928-684-3296
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2045111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
860596634OtherFEDERAL TAX ID NUMBER
860596634OtherFEDERAL TAX ID NUMBER