Provider Demographics
NPI:1467643080
Name:HARRIS, THERESA L (DC)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:L
Last Name:HARRIS
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 1:2050 SW 7TH PL
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-1852
Mailing Address - Country:US
Mailing Address - Phone:678-570-6146
Mailing Address - Fax:888-304-5851
Practice Address - Street 1:1306 E SILVER SPRINGS BLVD UNIT 102
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-6800
Practice Address - Country:US
Practice Address - Phone:352-622-6622
Practice Address - Fax:888-304-5851
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008216111N00000X
FLCH10004111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty