Provider Demographics
NPI:1215214051
Name:HARRIS, ASHLEE (ATC)
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3850 PROLOGIS PKWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-8334
Mailing Address - Country:US
Mailing Address - Phone:610-614-3003
Mailing Address - Fax:
Practice Address - Street 1:3850 PROLOGIS PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-8334
Practice Address - Country:US
Practice Address - Phone:610-614-3003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0048862255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
22OtherPROVIDER CODE