Individual
GABRIEL M HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
2100 W MAIN ST, RUSSELLVILLE, AR 72801-2758
(479) 968-2525
(479) 968-2538
Mailing address
2100 W MAIN ST, RUSSELLVILLE, AR 72801-2758
(479) 968-2525
(479) 968-2538
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3741
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200789721
—
AR
01
—
A002
TRICARE
AR
Enumeration date
08/28/2013
Last updated
02/10/2014
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