Provider Demographics
NPI:1043858483
Name:HARRINGTON, JIM
Entity Type:Individual
Prefix:
First Name:JIM
Middle Name:
Last Name:HARRINGTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 LIVINGSTON BLVD STE 4A2
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-8345
Mailing Address - Country:US
Mailing Address - Phone:989-619-4204
Mailing Address - Fax:
Practice Address - Street 1:800 LIVINGSTON BLVD STE 4A2
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-8345
Practice Address - Country:US
Practice Address - Phone:989-619-4204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator