Provider Demographics
NPI:1356524532
Name:MORRIS, BRIAN KENT (DC)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:KENT
Last Name:MORRIS
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 1:207 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
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-11
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5361111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU17660Medicare UPIN
FL70923Medicare PIN