Provider Demographics
NPI:1952559106
Name:HARRIGAN, LISA M (DC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:HARRIGAN
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 1:5024 DEERFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-3472
Mailing Address - Country:US
Mailing Address - Phone:580-402-0963
Mailing Address - Fax:580-237-0909
Practice Address - Street 1:117 N GRAND ST
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-4121
Practice Address - Country:US
Practice Address - Phone:580-402-0963
Practice Address - Fax:580-237-0909
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-29
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3858111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor