Provider Demographics
NPI:1700887163
Name:MORRIS CHIROPRACTIC CENTER, P.A.
Entity Type:Organization
Organization Name:MORRIS CHIROPRACTIC CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-684-8540
Mailing Address - Street 1:207 KINGSWAY RD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33510-4603
Mailing Address - Country:US
Mailing Address - Phone:813-684-8540
Mailing Address - Fax:813-651-1565
Practice Address - Street 1:207 KINGSWAY RD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33510-4603
Practice Address - Country:US
Practice Address - Phone:813-684-8540
Practice Address - Fax:813-651-1565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005361111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U17660Medicare UPIN
FL70923Medicare PIN