Healthcare Provider Details

I. General information

NPI: 1306820337
Provider Name (Legal Business Name): JEFFREY DEAN HARRISON DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2005
Last Update Date: 12/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2151 MILITARY ST S
HAMILTON AL
35570-6651
US

IV. Provider business mailing address

2151 MILITARY ST S
HAMILTON AL
35570-6651
US

V. Phone/Fax

Practice location:
  • Phone: 205-921-2348
  • Fax: 205-921-2061
Mailing address:
  • Phone: 205-921-2348
  • Fax: 205-921-2061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1868
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: