Individual
MR. JUAN R HARRIS SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.O.T.A./L
Contact information
Practice address
1800 BLUEGRASS AVE, LOUISVILLE, KY 40215-1130
(502) 502-3612
Mailing address
5813 PIKEWOOD RD, LOUISVILLE, KY 40219-5524
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A2832
KY
Other
Enumeration date
06/02/2015
Last updated
06/02/2015
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