Individual
JESSICA LYNN HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
506 LENOX AVE, NEW YORK, NY 10037-1802
(212) 939-1000
Mailing address
18101 OAKWOOD BLVD, DEARBORN, MI 48124-4089
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
5101024186
MI
2085R0202X
Diagnostic Radiology Physician
Primary
5151013312
MI
2085R0202X
Diagnostic Radiology Physician
95566
GA
Other
Enumeration date
06/19/2018
Last updated
06/21/2023
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