Provider Demographics
NPI:1770824104
Name:HARRIS, ANTHONY DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:DAVID
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 1:860 TOWNE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-3468
Mailing Address - Country:US
Mailing Address - Phone:407-483-1266
Mailing Address - Fax:407-483-1269
Practice Address - Street 1:860 TOWNE CENTER DR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-3468
Practice Address - Country:US
Practice Address - Phone:407-483-1266
Practice Address - Fax:407-483-1269
Is Sole Proprietor?:No
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10767111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor