Individual
MICHIAL WILLIAM HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
2849 BOARDWALK AVE, LEBANON, MO 65536-4476
(417) 664-3598
Mailing address
2849 BOARDWALK AVE, LEBANON, MO 65536-4476
(417) 664-3598
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2010018702
MO
Other
Enumeration date
08/31/2010
Last updated
08/31/2010
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