Provider Demographics
NPI:1225044076
Name:HARBIN, DEBRA REA (DC)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:REA
Last Name:HARBIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2416 W SHAW AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-3303
Mailing Address - Country:US
Mailing Address - Phone:559-439-4439
Mailing Address - Fax:559-439-4448
Practice Address - Street 1:2416 W SHAW AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3303
Practice Address - Country:US
Practice Address - Phone:559-439-4439
Practice Address - Fax:559-439-4448
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC14387111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT05329Medicare UPIN