Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | CH11002 | GA |
NPI | 1073014361 |
---|---|
Provider Name | Mrs. Eriece Bradford Harris |
First Address | Morrow, GA 30260 |
Second Address | Morrow, GA 30260-4153 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2018 |
Last Update Date | 22/02/2018 |