Individual
CHARLIE HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1450 ALTA VISTA ST, DUBUQUE, IA 52001-4327
(763) 249-5287
Mailing address
11502 MEADOW LN NE, BLAINE, MN 55449-5917
(763) 249-5287
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/09/2020
Last updated
02/09/2020
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