Provider Demographics
NPI:1831593805
Name:HARMON, DONALD (ATC)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:
Last Name:HARMON
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:ASHBURNHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01430-1500
Mailing Address - Country:US
Mailing Address - Phone:978-827-7046
Mailing Address - Fax:978-827-7099
Practice Address - Street 1:39 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:ASHBURNHAM
Practice Address - State:MA
Practice Address - Zip Code:01430-1500
Practice Address - Country:US
Practice Address - Phone:978-827-7046
Practice Address - Fax:978-827-7099
Is Sole Proprietor?:No
Enumeration Date:2014-10-20
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11052255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer