Provider Demographics
NPI:1356576821
Name:HARRIS, SCOTT
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:HARRIS
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 1:1515 N 400 E
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-7561
Mailing Address - Country:US
Mailing Address - Phone:435-787-8895
Mailing Address - Fax:435-787-8654
Practice Address - Street 1:1515 N 400 E
Practice Address - Street 2:SUITE 105
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-7561
Practice Address - Country:US
Practice Address - Phone:435-787-8895
Practice Address - Fax:435-787-8654
Is Sole Proprietor?:No
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter