Provider Demographics
NPI:1174604268
Name:SEUBOLD, MORGAN A (DC)
Entity type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:A
Last Name:SEUBOLD
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:PO BOX 924
Mailing Address - Street 2:
Mailing Address - City:ROLAND
Mailing Address - State:OK
Mailing Address - Zip Code:74954-0924
Mailing Address - Country:US
Mailing Address - Phone:918-427-3630
Mailing Address - Fax:918-427-3681
Practice Address - Street 1:1022 E RAY FINE BLVD
Practice Address - Street 2:STE 4
Practice Address - City:ROLAND
Practice Address - State:OK
Practice Address - Zip Code:74954
Practice Address - Country:US
Practice Address - Phone:918-427-3630
Practice Address - Fax:918-427-3681
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK20060642111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor