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Individual

MR. JEFFREY ALAN HARRIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.D.O

Contact information

Practice address
220 N BASIL ST, BALTIMORE, OH 43105-1004
(740) 862-8381
Mailing address
220 N BASIL ST, BALTIMORE, OH 43105-1004
(740) 862-8381

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
967S
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0603421
OH
Enumeration date
04/02/2007
Last updated
07/09/2007
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