Provider Demographics
NPI:1417037920
Name:HARRISON, ERIC J (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:J
Last Name:HARRISON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2828 W 4700 S
Mailing Address - Street 2:SUITE A
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84118-2154
Mailing Address - Country:US
Mailing Address - Phone:801-966-3101
Mailing Address - Fax:801-966-0161
Practice Address - Street 1:2828 W 4700 S
Practice Address - Street 2:SUITE A
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84118-2154
Practice Address - Country:US
Practice Address - Phone:801-966-3101
Practice Address - Fax:801-966-0161
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4858449-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTV06363Medicare UPIN