Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 3532-012 | WI |
NPI | 1194806166 |
---|---|
Provider Name | Dr. Craig Richard Morris |
First Address | Plymouth, WI 53073-1807 |
Second Address | Plymouth, WI 53073-1807 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 18/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U71834 | (02) | WI |