Individual
MR. SHANE HARBAUGH I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
104 E 8TH ST, CLAY CITY, IN 47841-1302
(812) 939-2900
Mailing address
104 E 8TH ST, CLAY CITY, IN 47841-1302
(812) 939-2900
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
8906379165
IN
Other
Enumeration date
03/11/2014
Last updated
03/11/2014
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