Provider Demographics
NPI:1467507533
Name:HARRIS, SHARI LOU (RPT)
Entity Type:Individual
Prefix:MS
First Name:SHARI
Middle Name:LOU
Last Name:HARRIS
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 355
Mailing Address - Street 2:28500 COUNTY ROAD 6210
Mailing Address - City:EDGAR SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:65462-0355
Mailing Address - Country:US
Mailing Address - Phone:573-435-9361
Mailing Address - Fax:573-435-9361
Practice Address - Street 1:28500 COUNTY ROAD 6210
Practice Address - Street 2:
Practice Address - City:EDGAR SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:65462
Practice Address - Country:US
Practice Address - Phone:573-435-9361
Practice Address - Fax:573-435-9361
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO02095225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist