John Alfred Harris, P.T., A.T.C.

Individual provider Active NPI Physical Therapist · Jonesborough, TN

NPI 1730196148 · NPPES record last updated Jul 23, 2014

Key facts

NPI
1730196148
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
1421 (TN)
Practice address
900 E Jackson Blvd
Ste 4
Jonesborough, TN 37659-1505
Phone
(423) 218-1751
Fax
(423) 218-1752
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1421 TN Yes

Addresses

Primary practice location

900 E Jackson Blvd
Ste 4
Jonesborough, TN 37659-1505

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-8907

Other identifiers

IdentifierTypeStateIssuer
0446557MedicaidTN
3127120OtherTNBC/BS OF TN

Other providers in Jonesborough, TN

All providers in Jonesborough, TN · Physical Therapist in Tennessee

Sources for this page

Verify at the official NPI Registry.