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General NPI Number Information
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NPI Number | 1538354808
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Entity Type | Organization
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Legal Business Name | HARRISON R TODD II DC PLC
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 02/27/2008
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Provider Practice Location Address
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Address Line | 1703 24TH ST
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City | VERO BEACH
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State | FL
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Zip | 32960-3351
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Country | US
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Telephone | 772-562-2053
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Fax | 772-562-8197
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Provider Business Mailing Address
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Address Line | 1703 24TH ST
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City | VERO BEACH
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State | FL
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Zip | 32960-3351
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Country | US
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Telephone | 772-562-2053
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Fax | 772-562-8197
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | HARRISON ROGERS TODD II
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Credential | D.C.
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Telephone | 772-562-2053
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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 | CH5790
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License Number State | FL
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