Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 10825040 | UT |
NPI | 1730522350 |
---|---|
Provider Name | Amy Jean Harlow |
First Address | Fort Myers, FL 33908-3732 |
Second Address | Fort Myers, FL 33908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2013 |
Last Update Date | 11/10/2019 |