Healthcare Provider Details

I. General information

NPI: 1063641553
Provider Name (Legal Business Name): JOSHUA KIRK HARRISON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2009
Last Update Date: 11/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 S NIAGARA ST STE 360
DENVER CO
80224-1681
US

IV. Provider business mailing address

925 S NIAGARA ST STE 360
DENVER CO
80224-1681
US

V. Phone/Fax

Practice location:
  • Phone: 303-349-5492
  • Fax: 866-274-1128
Mailing address:
  • Phone: 303-349-5492
  • Fax: 866-274-1128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number5142
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: