Provider Demographics
NPI:1932257649
Name:KUTZNER, MORGAN ANTHONY (DC)
Entity Type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:ANTHONY
Last Name:KUTZNER
Suffix:
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 1:5000 OLD BUNCOMBE RD
Mailing Address - Street 2:SUITE 19
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29617-8208
Mailing Address - Country:US
Mailing Address - Phone:864-294-0010
Mailing Address - Fax:864-294-8221
Practice Address - Street 1:5000 OLD BUNCOMBE RD
Practice Address - Street 2:SUITE 19
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29617-8208
Practice Address - Country:US
Practice Address - Phone:864-294-0010
Practice Address - Fax:864-294-8221
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC780111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT242280281Medicare PIN