Provider Demographics
NPI:1902194590
Name:HARLOW, RICHARD H
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:H
Last Name:HARLOW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3123 THORNTON ST NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-4838
Mailing Address - Country:US
Mailing Address - Phone:330-575-2543
Mailing Address - Fax:
Practice Address - Street 1:3123 THORNTON ST NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-4838
Practice Address - Country:US
Practice Address - Phone:330-575-2543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-15
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRS268279172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver