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Individual

MRS. TIFFANY JOY HARRISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
325 MAINE ST., LAWRENCE, KS 66044
(785) 505-3780
(785) 505-5294
Mailing address
325 MAINE ST., LAWRENCE, KS 66044
(785) 505-3780
(785) 505-5294

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-04454
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
068002400
MEDICARE PTAN
KS
05
201137050A
KS
Enumeration date
08/21/2012
Last updated
01/26/2022
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