Provider Demographics
NPI:1255415675
Name:MORRIS, KENNETH CHRIS (DC)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:CHRIS
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 1:10515 BELLS FERRY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-4204
Mailing Address - Country:US
Mailing Address - Phone:770-704-0114
Mailing Address - Fax:770-704-0115
Practice Address - Street 1:10515 BELLS FERRY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-4204
Practice Address - Country:US
Practice Address - Phone:770-704-0114
Practice Address - Fax:770-704-0115
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA006629111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCJMPMedicare ID - Type Unspecified