Provider Demographics
NPI:1164657466
Name:HARRIS, BRYANT CHRISTOPHER (DC)
Entity Type:Individual
Prefix:
First Name:BRYANT
Middle Name:CHRISTOPHER
Last Name:HARRIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 BESTGATE RD.
Mailing Address - Street 2:#205
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-2792
Mailing Address - Country:US
Mailing Address - Phone:443-333-9876
Mailing Address - Fax:443-433-0870
Practice Address - Street 1:2525 RIVA RD STE 145
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7437
Practice Address - Country:US
Practice Address - Phone:443-333-9876
Practice Address - Fax:443-433-0870
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-16
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCCH030091111N00000X
CADC31251111N00000X
MDS03734111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor