Provider Demographics
NPI:1255679353
Name:HARMON, PETER ALLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:ALLEN
Last Name:HARMON
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 1:3875 230TH ST E
Mailing Address - Street 2:
Mailing Address - City:PRIOR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55372-8887
Mailing Address - Country:US
Mailing Address - Phone:612-237-9532
Mailing Address - Fax:612-886-2293
Practice Address - Street 1:6410 NICOLLET AVE
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-1613
Practice Address - Country:US
Practice Address - Phone:612-886-2311
Practice Address - Fax:612-886-2293
Is Sole Proprietor?:No
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5733111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor