Provider Demographics
NPI:1669789152
Name:HARRIS, COLIN ERIC (CMT)
Entity type:Individual
Prefix:MR
First Name:COLIN
Middle Name:ERIC
Last Name:HARRIS
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1219 S YOSEMITE WAY
Mailing Address - Street 2:UNIT 63
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-2268
Mailing Address - Country:US
Mailing Address - Phone:720-278-6610
Mailing Address - Fax:
Practice Address - Street 1:1219 S YOSEMITE WAY
Practice Address - Street 2:UNIT 63
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80247-2268
Practice Address - Country:US
Practice Address - Phone:720-278-6610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-07
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9930225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist