Provider Demographics
NPI:1942367099
Name:LARRY A. HARRIS
Entity Type:Organization
Organization Name:LARRY A. HARRIS
Other - Org Name:HARRIS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:931-368-1996
Mailing Address - Street 1:664 SANGO RD.
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-5489
Mailing Address - Country:US
Mailing Address - Phone:931-368-1996
Mailing Address - Fax:931-368-0448
Practice Address - Street 1:664 SANGO RD.
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-5489
Practice Address - Country:US
Practice Address - Phone:931-368-1996
Practice Address - Fax:931-368-0448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN142515OtherBCBS
TN142515OtherBCBS