Individual
GREGORY HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.T.C
Contact information
Practice address
1350 BROADCASTING RD, 201, WYOMISSING, PA 19610-3229
(610) 685-9600
Mailing address
80 LOOSE LN, LEESPORT, PA 19533-8628
(610) 698-3098
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT004924
PA
Other
Enumeration date
01/26/2012
Last updated
01/26/2012
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