Organization
PROVIDER PROVIDER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN HARRIS PHYSICIAN ASSISTANT (PA-C/MEMBER OF CORPORATION)
(480) 461-9822
Entity
Organization
Contact information
Practice address
841 W 11TH ST, MESA, AZ 85201-3109
(480) 461-9822
Mailing address
841 W 11TH ST, MESA, AZ 85201-3109
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
07/28/2018
Last updated
12/20/2018
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