Individual
MR. JOSHUA MICHAEL HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
4800 MEXICO RD SUITE 104, SAINT PETERS, MO 63376-1665
(314) 304-3873
Mailing address
2413 CHRISTOPHER VIEW DR, SAINT LOUIS, MO 63129-5545
(314) 304-3873
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2015022200
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/04/2015
Last updated
07/28/2015
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