Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 44991 | WI |
N | 207QA0505X | Family Doctor - Adult Medicine | 44991-020 | WI |
NPI | 1316973167 |
---|---|
Provider Name | Allison K Harbour |
First Address | Iron Mountain, MI 49801-4760 |
Second Address | Iron Mountain, MI 49801-4760 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 09/01/2019 |