Chris Harris, PTA

Individual provider Active NPI Physical Therapy Assistant · Andale, KS

NPI 1982153276 · NPPES record last updated Sep 27, 2016

Key facts

NPI
1982153276
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
A-0791 (NM)
Practice address
24124 W 37TH St N
Andale, KS 67001-9660
Phone
(505) 977-1793
NPI assigned
Sep 27, 2016
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
A-0791NMMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A-0791 NM Yes

Addresses

Primary practice location

24124 W 37TH St N
Andale, KS 67001-9660

Mailing address

24124 W 37TH St N
Andale, KS 67001-9660
Phone (505) 977-1793

Other providers in Andale, KS

All providers in Andale, KS · Physical Therapy Assistant in Kansas

Sources for this page

Verify at the official NPI Registry.