Provider Demographics
NPI:1417132531
Name:HARDISON, TODD ANDREW (DC)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:ANDREW
Last Name:HARDISON
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 1:1020 BARBER CREEK DR STE 310
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-5996
Mailing Address - Country:US
Mailing Address - Phone:706-850-5595
Mailing Address - Fax:706-850-5883
Practice Address - Street 1:1020 BARBER CREEK DR STE 310
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-5996
Practice Address - Country:US
Practice Address - Phone:706-850-5595
Practice Address - Fax:706-850-5883
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006310111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1609150705OtherGROUP NPI