Provider Demographics
NPI:1124798285
Name:HARRISON, CONSTANCE (DC)
Entity type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:
Last Name:HARRISON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 E MAIN ST # 0E
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-5727
Mailing Address - Country:US
Mailing Address - Phone:678-904-2074
Mailing Address - Fax:678-648-2243
Practice Address - Street 1:1400 BUFORD HWY STE K7
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-8776
Practice Address - Country:US
Practice Address - Phone:678-904-2074
Practice Address - Fax:678-648-2243
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO11234111N00000X
TN3438111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor