Provider Demographics
NPI:1336348283
Name:MORLOCK CHIROPRACTIC CENTER LTD
Entity Type:Organization
Organization Name:MORLOCK CHIROPRACTIC CENTER LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:P
Authorized Official - Last Name:MORLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:218-233-4402
Mailing Address - Street 1:1602 30TH AVE S
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-5152
Mailing Address - Country:US
Mailing Address - Phone:218-233-4402
Mailing Address - Fax:218-233-1026
Practice Address - Street 1:1602 30TH AVE S
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-5152
Practice Address - Country:US
Practice Address - Phone:218-233-4402
Practice Address - Fax:218-233-1026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty