Provider Demographics
NPI:1023609856
Name:MORRIS, TYLER (DC)
Entity type:Individual
Prefix:DR
First Name:TYLER
Middle Name:
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 1:189 PROFESSIONAL CT SE STE 101
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-7051
Mailing Address - Country:US
Mailing Address - Phone:678-232-8670
Mailing Address - Fax:
Practice Address - Street 1:189 PROFESSIONAL CT SE STE 101
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-7051
Practice Address - Country:US
Practice Address - Phone:678-232-8670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010406111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician