Provider Demographics
NPI:1669630224
Name:HARMON, DAVID DEAN (LMT,NCTMB,AMTA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:DEAN
Last Name:HARMON
Suffix:
Gender:M
Credentials:LMT,NCTMB,AMTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-4391
Mailing Address - Country:US
Mailing Address - Phone:308-520-7789
Mailing Address - Fax:308-532-0370
Practice Address - Street 1:1717 E 4TH ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-4391
Practice Address - Country:US
Practice Address - Phone:308-520-7789
Practice Address - Fax:308-532-0370
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2124174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist