Provider Demographics
NPI:1841503497
Name:HARSMA, DAVID R (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:HARSMA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5644 HAMILTON RD
Mailing Address - Street 2:
Mailing Address - City:JORDAN
Mailing Address - State:NY
Mailing Address - Zip Code:13080-9504
Mailing Address - Country:US
Mailing Address - Phone:315-689-7494
Mailing Address - Fax:315-689-7494
Practice Address - Street 1:527 CHARLES AVE
Practice Address - Street 2:
Practice Address - City:SOLVAY
Practice Address - State:NY
Practice Address - Zip Code:13209-1727
Practice Address - Country:US
Practice Address - Phone:315-689-7494
Practice Address - Fax:315-689-7494
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX002108-1111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition