Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 985 | OH |
NPI | 1063561678 |
---|---|
Provider Name | Robert H. Harris |
First Address | Woodmere, OH 44122-4638 |
Second Address | Woodmere, OH 44122-4638 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2007 |
Last Update Date | 28/12/2012 |