Provider Demographics
NPI:1609819374
Name:HARRIS, JOHN ALBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ALBERT
Last Name:HARRIS
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 1:23 PENNSBURY WAY W
Mailing Address - Street 2:
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317-9306
Mailing Address - Country:US
Mailing Address - Phone:610-388-9783
Mailing Address - Fax:
Practice Address - Street 1:736 BALTIMORE PIKE
Practice Address - Street 2:SUITE 2
Practice Address - City:CONCORDVILLE
Practice Address - State:PA
Practice Address - Zip Code:19331-0808
Practice Address - Country:US
Practice Address - Phone:610-459-1580
Practice Address - Fax:610-459-5998
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-003475L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor