Individual
MR. STANLEY JENKINS HARRIS
Active
Individual
MR. STANLEY JENKINS HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
775
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129283721
—
AR
01
—
5G468
MEDICARE GROUP
AR
01
—
5S488
BLUE CROSS BLUE SHIELD
AR
Enumeration date
04/28/2006
Last updated
08/22/2011
Update your record
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