Individual
MR. TONY HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
1600 UNIVERSITY AVE, MEYER WELLNESS CENTER, BOLIVAR, MO 65613-2578
(417) 777-7763
(417) 777-4378
Mailing address
1500 N OAKLAND AVE, BOLIVAR, MO 65613-3011
(417) 777-7763
(417) 777-4378
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2007028020
MO
Other
Enumeration date
05/16/2014
Last updated
05/16/2014
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