Individual
IAN WINFRED HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2617 SIR WALTER RD, GREENSBORO, NC 27405-5453
(336) 509-8136
Mailing address
2617 SIR WALTER RD, GREENSBORO, NC 27405-5453
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A4542
NC
Other
Enumeration date
03/20/2012
Last updated
03/20/2012
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