Individual
MR. ROBERT CHARLES HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
21800 CANYON DR, WILDOMAR, CA 92595-9181
(951) 253-7200
Mailing address
27031 N BAY LN, MENIFEE, CA 92585-5602
(909) 261-4219
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2255A2300X
—
CA
Enumeration date
11/12/2021
Last updated
11/12/2021
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