Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT011310 | GA |
Y | 2251X0800X | Physical Therapist - Orthopedic | PT011310 | GA |
NPI | 1023449048 |
---|---|
Provider Name | Dr. Ashley Burns Harris |
First Address | Atlanta, GA 30329-2248 |
Second Address | Atlanta, GA 30329-2248 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2013 |
Last Update Date | 01/12/2013 |