Provider Demographics
NPI:1457061475
Name:MORGAN, HEATHER (DC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3510 VALLEY HILL RD NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-3236
Mailing Address - Country:US
Mailing Address - Phone:770-355-3645
Mailing Address - Fax:
Practice Address - Street 1:3510 VALLEY HILL RD NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-3236
Practice Address - Country:US
Practice Address - Phone:770-355-3645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5920111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition