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STEVEN VANCE HARRISON III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
370 E VIRGINIA AVE STE 100, PHOENIX, AZ 85004-1254
(602) 258-4788
Mailing address
PO BOX 7587, PHOENIX, AZ 85011-7587
(602) 258-4788

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
52074
CA
363AS0400X
Surgical Physician Assistant
Primary
6077
AZ

Other

Enumeration date
10/30/2014
Last updated
10/07/2015
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