Individual
MR. SAMUEL HARRIS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
910 E OKLAHOMA AVE, GRAND ISLAND, NE 68801-8146
(405) 921-4498
Mailing address
910 E OKLAHOMA AVE, GRAND ISLAND, NE 68801-8146
(405) 921-4498
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
879
NE
Other
Enumeration date
01/02/2015
Last updated
01/02/2015
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