Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | TN | |
Y | 222Z00000X | Podiatrist | TN | |
N | 224P00000X | Prosthetist | TN |
NPI | 1134453186 |
---|---|
Provider Name | Joe C Harmon |
First Address | Mphs, TN 38104 |
Second Address | Mphs, TN 38104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2009 |
Last Update Date | 23/09/2009 |