Individual
DR. JORDAN DANIEL HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2829 E OAKLAND AVE STE 1, JOHNSON CITY, TN 37601-1908
(423) 282-4590
Mailing address
199 GRANDE HARBOR WAY, BLOUNTVILLE, TN 37617-6421
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3403
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q029353
—
TN
Enumeration date
06/21/2017
Last updated
12/23/2019
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