Provider Demographics
NPI:1497418065
Name:HARRIS, LAVARIUS CHRISTOPHER
Entity Type:Individual
Prefix:
First Name:LAVARIUS
Middle Name:CHRISTOPHER
Last Name:HARRIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 LAYARD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-4421
Mailing Address - Country:US
Mailing Address - Phone:205-568-1011
Mailing Address - Fax:
Practice Address - Street 1:1608 LAYARD DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-4421
Practice Address - Country:US
Practice Address - Phone:205-568-1011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management