Individual
TINA M HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
270 N FRANKLIN AVE, COLBY, KS 67701-2322
(785) 462-8008
(785) 460-8080
Mailing address
270 N FRANKLIN AVE, COLBY, KS 67701-2322
(785) 462-8008
(785) 460-8080
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
11-2054
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
059714
BLUE CROSS BLUE SHIELD
—
05
—
100319310A
—
KS
01
—
650005073
RAILROAD MEDICARE
—
Enumeration date
06/08/2006
Last updated
06/16/2009
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