Individual
CHARLYN ANNISE HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3060 NAPIER AVE STE B, MACON, GA 31204-3872
(470) 269-2109
Mailing address
2865 CHURCHILL ST, MACON, GA 31204-5260
(470) 269-2109
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
—
—
224P00000X
Prosthetist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
01/13/2021
Last updated
04/17/2023
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