Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | CR2580 | ME |
Y | 111NI0013X | Independent Medical Examiner | CR2580 | ME |
NPI | 1881948768 |
---|---|
Provider Name | Dr. Crystal Theresa Zagwyn Harrison |
First Address | Richmond, ME 04357-4036 |
Second Address | Richmond, ME 04357-4036 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2012 |
Last Update Date | 04/01/2022 |