Individual
CHARLES BRADLEY HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1330 BOILING SPRINGS RD, SUITE 1600, SPARTANBURG, SC 29303
(864) 582-6396
(864) 582-1608
Mailing address
1330 BOILING SPRINGS RD, SUITE 1600, SPARTANBURG, SC 29303
(864) 582-6396
(864) 582-1608
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1028
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0408PA
—
SC
Enumeration date
08/10/2006
Last updated
02/24/2014
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