Provider Demographics
NPI:1700616679
Name:HARRISON CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:HARRISON CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-961-1822
Mailing Address - Street 1:1122 DUSTIN DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-4908
Mailing Address - Country:US
Mailing Address - Phone:918-961-1822
Mailing Address - Fax:
Practice Address - Street 1:1122 DUSTIN DR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-4908
Practice Address - Country:US
Practice Address - Phone:918-961-1822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-06
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty