Individual
HOMER MCCOY HARRISON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3663 ARCH RD, STOCKTON, CA 95215-8315
(209) 943-2202
Mailing address
2421 GRIMSBY DR, ANTIOCH, CA 94509-5866
(925) 778-2358
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10433
CA
Other
Enumeration date
02/09/2007
Last updated
07/08/2007
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