Provider Demographics
NPI:1891967873
Name:HARRISON, JAY MORGAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:MORGAN
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 1:2637 IRA E WOODS AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-9013
Mailing Address - Country:US
Mailing Address - Phone:817-310-0301
Mailing Address - Fax:817-423-6701
Practice Address - Street 1:2637 IRA E WOODS AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-9013
Practice Address - Country:US
Practice Address - Phone:817-310-0301
Practice Address - Fax:817-423-6701
Is Sole Proprietor?:No
Enumeration Date:2008-03-30
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556601111N00000X
TX11382111N00000X
UT69976151202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor