Provider Demographics
NPI:1093938961
Name:HARRIS FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:HARRIS FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:K
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-489-8645
Mailing Address - Street 1:753 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TRAPPE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-1948
Mailing Address - Country:US
Mailing Address - Phone:610-489-8645
Mailing Address - Fax:610-489-6329
Practice Address - Street 1:753 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TRAPPE
Practice Address - State:PA
Practice Address - Zip Code:19426-1948
Practice Address - Country:US
Practice Address - Phone:610-489-8645
Practice Address - Fax:610-489-6329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007490L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1104972660OtherNPI PROVIDER NUMBER
PA0872747000OtherAMERIHEALTH
PA0872747000OtherIBC
PA0872747000OtherKEYSTONE
PA1104972660OtherNPI PROVIDER NUMBER
PAHA070034Medicare ID - Type UnspecifiedMEDICARE
PA0872747000OtherAMERIHEALTH