Provider Demographics
NPI:1649090424
Name:MORGAN, DEVERICK TEMUEL SR (DC)
Entity type:Individual
Prefix:DR
First Name:DEVERICK
Middle Name:TEMUEL
Last Name:MORGAN
Suffix:SR
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 1:397 YOUNG JAMES CIR
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-1470
Mailing Address - Country:US
Mailing Address - Phone:678-779-9841
Mailing Address - Fax:
Practice Address - Street 1:260 CORPORATE CENTER DR STE E
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7215
Practice Address - Country:US
Practice Address - Phone:678-779-9841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO11262111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor