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Individual

DR. EDWIN L HARLESS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
190 KIMEL PARK RD, VA OUTPATIENT CLINIC, WINSTON-SALEM, NC 27103
(336) 768-3296
(336) 760-5496
Mailing address
3531 STANCLIFF RD, CLEMMONS, NC 27012-8522
(336) 766-0778

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1428
NC

Other

Enumeration date
03/24/2006
Last updated
07/08/2007
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