Provider Demographics
NPI:1255368908
Name:HARKNESS, GEORGE (MHA, ATC)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:HARKNESS
Suffix:
Gender:M
Credentials:MHA, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 BOYER DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-7738
Mailing Address - Country:US
Mailing Address - Phone:803-351-1616
Mailing Address - Fax:
Practice Address - Street 1:300 COLLEGE ST NE
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29117-0001
Practice Address - Country:US
Practice Address - Phone:803-516-4741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer