Individual
CAROL HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1760 SHAWANO AVE, GREEN BAY, WI 54303-3216
(920) 499-5191
Mailing address
1760 SHAWANO AVE, GREEN BAY, WI 54303-3216
(920) 499-5191
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5381-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40335500
—
WI
Enumeration date
05/14/2008
Last updated
05/14/2008
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