1124652870 NPI number — DUSTIN J MORROW LLC

Table of content: (NPI 1124652870)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124652870 NPI number — DUSTIN J MORROW LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DUSTIN J MORROW LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BALANCE COUNSELNG & CONSULTING
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124652870
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/31/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1384 MARTIN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALEXANDER
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72002-9665
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2213 N REYNOLDS RD STE 26
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRYANT
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72022-2581
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-303-6108
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/02/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MORROW
Authorized Official First Name:
DUSTIN
Authorized Official Middle Name:
J
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
501-303-6108

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)