Individual
JITCSADAPORN LYNNIE HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
700 19TH ST S, BIRMINGHAM, AL 35233-1927
(205) 933-8101
Mailing address
700 19TH ST S, BIRMINGHAM, AL 35233-1927
(205) 933-8101
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1320
AL
Other
Enumeration date
04/02/2018
Last updated
10/09/2018
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