Provider Demographics
NPI:1508068669
Name:MORTON HEALTHCARE PC
Entity Type:Organization
Organization Name:MORTON HEALTHCARE PC
Other - Org Name:MORTON FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-649-0800
Mailing Address - Street 1:12840 SPRINKLE RD
Mailing Address - Street 2:#3
Mailing Address - City:VICKSBURG
Mailing Address - State:MI
Mailing Address - Zip Code:49097-8395
Mailing Address - Country:US
Mailing Address - Phone:269-649-0800
Mailing Address - Fax:269-649-4000
Practice Address - Street 1:12840 SPRINKLE RD
Practice Address - Street 2:#3
Practice Address - City:VICKSBURG
Practice Address - State:MI
Practice Address - Zip Code:49097-8395
Practice Address - Country:US
Practice Address - Phone:269-649-0800
Practice Address - Fax:269-649-4000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008085111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty