Individual
SEAN LELEN HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
126 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-8952
(573) 596-1765
Mailing address
126 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-8952
(573) 596-1765
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
14-105728-102
KS
Other
Enumeration date
07/19/2012
Last updated
07/19/2012
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