Provider Demographics
NPI:1881891497
Name:HARRIS, VANESSA CARRIGAN (LPTA)
Entity type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:CARRIGAN
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3170 US HIGHWAY 64 90 W
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28681-7580
Mailing Address - Country:US
Mailing Address - Phone:828-635-0725
Mailing Address - Fax:
Practice Address - Street 1:3170 US HIGHWAY 64 90 W
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28681-7580
Practice Address - Country:US
Practice Address - Phone:828-635-0725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1447261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy