Provider Demographics
NPI:1134282791
Name:HARRIS, MARC (ND)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:
Last Name:HARRIS
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 N 19TH AVE
Mailing Address - Street 2:SUITE 1D
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-6069
Mailing Address - Country:US
Mailing Address - Phone:406-586-1997
Mailing Address - Fax:
Practice Address - Street 1:702 N 19TH AVE
Practice Address - Street 2:SUITE 1D
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-6069
Practice Address - Country:US
Practice Address - Phone:406-586-1997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT57175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath