Provider Demographics
NPI:1588236517
Name:HARPER, VICTORIA E (DC)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:E
Last Name:HARPER
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 1:3110 GRAND AVE APT 4109
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33782-6173
Mailing Address - Country:US
Mailing Address - Phone:704-490-8042
Mailing Address - Fax:
Practice Address - Street 1:3110 GRAND AVE APT 4109
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782-6173
Practice Address - Country:US
Practice Address - Phone:704-490-8042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13616111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor