Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 6024 | CO |
NPI | 1326291188 |
---|---|
Provider Name | Dr. Andy Colby Harmon |
First Address | Longmont, CO 80503-7572 |
Second Address | Niwot, CO 80544 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2008 |
Last Update Date | 24/10/2008 |