Provider Demographics
NPI:1710340872
Name:HARRIS, MALEIGH
Entity Type:Individual
Prefix:MISS
First Name:MALEIGH
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6968 HIGHWAY 214 E
Mailing Address - Street 2:
Mailing Address - City:FISHER
Mailing Address - State:AR
Mailing Address - Zip Code:72429-9796
Mailing Address - Country:US
Mailing Address - Phone:870-974-0478
Mailing Address - Fax:
Practice Address - Street 1:7507 WARDEN RD
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120-5042
Practice Address - Country:US
Practice Address - Phone:501-301-4530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-05
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3899225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant