Provider Demographics
NPI:1003175035
Name:JERRY L. HARNISH DC INC
Entity Type:Organization
Organization Name:JERRY L. HARNISH DC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARNISH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:419-886-4444
Mailing Address - Street 1:110 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BELLVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44813-1021
Mailing Address - Country:US
Mailing Address - Phone:419-886-4444
Mailing Address - Fax:419-886-3731
Practice Address - Street 1:110 MAIN ST
Practice Address - Street 2:
Practice Address - City:BELLVILLE
Practice Address - State:OH
Practice Address - Zip Code:44813-1021
Practice Address - Country:US
Practice Address - Phone:419-886-4444
Practice Address - Fax:419-886-3731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-11
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1143111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty