Individual
MR. MARK HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
140 N OCEAN AVE, PATCHOGUE, NY 11772-2004
(631) 254-2225
Mailing address
82 CHANEL DR E, SHIRLEY, NY 11967-3812
(631) 281-2128
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
019351
NY
Other
Enumeration date
12/09/2006
Last updated
07/08/2007
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