Provider Demographics
NPI:1548409618
Name:HARRISON, STEPHANIE (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:HARRISON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 CLARK RD STE H1
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-2366
Mailing Address - Country:US
Mailing Address - Phone:941-926-1600
Mailing Address - Fax:
Practice Address - Street 1:3900 CLARK RD STE H1
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-2366
Practice Address - Country:US
Practice Address - Phone:941-926-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-13
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 9420111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor