Provider Demographics
NPI:1538825104
Name:MIHOLICS, MORGAN LEIGH (DC)
Entity type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:LEIGH
Last Name:MIHOLICS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:LEIGH
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2948 WINDLE LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH DAYTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32119-8533
Mailing Address - Country:US
Mailing Address - Phone:727-430-2079
Mailing Address - Fax:
Practice Address - Street 1:2948 WINDLE LN
Practice Address - Street 2:
Practice Address - City:SOUTH DAYTONA
Practice Address - State:FL
Practice Address - Zip Code:32119-8533
Practice Address - Country:US
Practice Address - Phone:727-430-2079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH13480111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1538825104OtherNPI