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General NPI Number Information
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NPI Number | 1295317493
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Entity Type | Individual
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Provider Name | TONYA LATRICE HARRIS DC
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Gender | Female
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Dates
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Enumeration Date | 04/27/2021
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Last Update Date | 05/26/2021
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Provider Practice Location Address
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Address Line | 2740 GREENBRIAR PKWY SW STE A3
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City | ATLANTA
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State | GA
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Zip | 30331
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Country | US
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Telephone | 404-629-9999
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Fax |
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Provider Business Mailing Address
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Address Line | 915 GLENWOOD AVE SE APT 604
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City | ATLANTA
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State | GA
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Zip | 30316-2188
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Country | US
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Telephone | 470-538-5170
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHIR010021
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License Number State | GA
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