Provider Demographics
NPI:1295124824
Name:HARRIS, SADIE JO (ATC/ L, LMT)
Entity type:Individual
Prefix:MRS
First Name:SADIE
Middle Name:JO
Last Name:HARRIS
Suffix:
Gender:F
Credentials:ATC/ L, LMT
Other - Prefix:MISS
Other - First Name:SADIE
Other - Middle Name:JO
Other - Last Name:COFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC/L, LMT
Mailing Address - Street 1:DEPARTMENT OF HEALTH AND HUMAN PERFORMANCE
Mailing Address - Street 2:MURPHY CENTER P. O. BOX 96
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37132-0001
Mailing Address - Country:US
Mailing Address - Phone:615-424-6912
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF HEALTH AND HUMAN PERFORMANCE
Practice Address - Street 2:AMG
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37132-0001
Practice Address - Country:US
Practice Address - Phone:615-424-6912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-20
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12972255A2300X
TN8143225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist