Provider Demographics
NPI:1962026518
Name:HARBISON, TIFFANY NICHOLE (PT, DPT)
Entity Type:Individual
Prefix:MISS
First Name:TIFFANY
Middle Name:NICHOLE
Last Name:HARBISON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 W NIFONG BLVD STE 121
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-6006
Mailing Address - Country:US
Mailing Address - Phone:573-442-5268
Mailing Address - Fax:
Practice Address - Street 1:10 W NIFONG BLVD STE 121
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-6006
Practice Address - Country:US
Practice Address - Phone:573-442-5268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-29
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist