Provider Demographics
NPI:1184968505
Name:HARRINGTON, BOBBI JEAN (IDMT)
Entity type:Individual
Prefix:
First Name:BOBBI
Middle Name:JEAN
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:IDMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 W MANHATTAN DR
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67204-5426
Mailing Address - Country:US
Mailing Address - Phone:316-258-0516
Mailing Address - Fax:
Practice Address - Street 1:2504 W MANHATTAN DR
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67204-5426
Practice Address - Country:US
Practice Address - Phone:316-258-0516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians