Individual
JASON W HARLESS
Active
Individual
JASON W HARLESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05010353A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100257920
GROUP MEDICAID
IN
01
—
156546
GROUP MEDICARE
IN
05
—
201004810A
—
IN
Enumeration date
06/08/2010
Last updated
05/16/2011
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