Provider Demographics
NPI:1700254174
Name:HARWOOD, SAM (DC, PA-C)
Entity Type:Individual
Prefix:DR
First Name:SAM
Middle Name:
Last Name:HARWOOD
Suffix:
Gender:M
Credentials:DC, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2345 EDWARD ST
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-6940
Mailing Address - Country:US
Mailing Address - Phone:785-764-2087
Mailing Address - Fax:
Practice Address - Street 1:3320 CLINTON PARKWAY CT
Practice Address - Street 2:STE 110
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66047-2629
Practice Address - Country:US
Practice Address - Phone:785-764-2087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-02
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05743207X00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery