Provider Demographics
NPI:1902020530
Name:HARSH, DAREN M (PTA)
Entity Type:Individual
Prefix:MR
First Name:DAREN
Middle Name:M
Last Name:HARSH
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 S NICKELPLATE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44641
Mailing Address - Country:US
Mailing Address - Phone:330-875-1300
Mailing Address - Fax:330-875-1311
Practice Address - Street 1:1421 S NICKELPLATE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:OH
Practice Address - Zip Code:44641
Practice Address - Country:US
Practice Address - Phone:330-875-1300
Practice Address - Fax:330-875-1311
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA-03860225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant