Provider Demographics
NPI:1780785444
Name:THE MORGAN CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:THE MORGAN CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:CORRINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-922-4782
Mailing Address - Street 1:1019 CHRISTIAN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-3707
Mailing Address - Country:US
Mailing Address - Phone:215-922-4782
Mailing Address - Fax:215-440-7539
Practice Address - Street 1:1019 CHRISTIAN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-3707
Practice Address - Country:US
Practice Address - Phone:215-922-4782
Practice Address - Fax:215-440-7539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003397L111N00000X
PADC008767L111N00000X
PADC008051L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA533176Medicare ID - Type Unspecified