Provider Demographics
NPI:1851571657
Name:HARRISON FAMILY CHIROPRACTIC CENTER, INC.
Entity Type:Organization
Organization Name:HARRISON FAMILY CHIROPRACTIC CENTER, INC.
Other - Org Name:KNIGHT CHIROPRACTIC CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:V.P. / PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:205-932-7620
Mailing Address - Street 1:324 3RD ST SE
Mailing Address - Street 2:
Mailing Address - City:FAYETTE
Mailing Address - State:AL
Mailing Address - Zip Code:35555-2936
Mailing Address - Country:US
Mailing Address - Phone:205-932-7620
Mailing Address - Fax:205-932-8742
Practice Address - Street 1:324 3RD ST SE
Practice Address - Street 2:
Practice Address - City:FAYETTE
Practice Address - State:AL
Practice Address - Zip Code:35555-2936
Practice Address - Country:US
Practice Address - Phone:205-932-7620
Practice Address - Fax:205-932-8742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1868111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALH880Medicare PIN