Individual
HARRISON JIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
THP
Contact information
Practice address
PO BOX 457, GANADO, AZ 86505-0457
(928) 755-4586
(928) 755-4747
Mailing address
PO BOX 457, GANADO, AZ 86505-0457
(928) 755-4586
(928) 755-4747
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
06/14/2024
Last updated
06/14/2024
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