Provider Demographics
NPI:1053543132
Name:MCMORRIS CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:MCMORRIS CHIROPRACTIC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:MCMORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:225-271-4083
Mailing Address - Street 1:27999 OLD STH WALKER RD
Mailing Address - Street 2:STE B
Mailing Address - City:WALKER
Mailing Address - State:LA
Mailing Address - Zip Code:70785-6048
Mailing Address - Country:US
Mailing Address - Phone:225-271-4083
Mailing Address - Fax:225-271-4208
Practice Address - Street 1:27999 OLD STH WALKER RD
Practice Address - Street 2:STE B
Practice Address - City:WALKER
Practice Address - State:LA
Practice Address - Zip Code:70785-6048
Practice Address - Country:US
Practice Address - Phone:225-271-4083
Practice Address - Fax:225-271-4208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-21
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1501111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty