MEDICARE: MS. JAIME L HARRIS MS, ATC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital

General Provider Information

NPI Number	:	1538194212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JAIME L HARRIS MS, ATC

Provider Business Mailing Address
First Line	:	325 CHERRY CHAPEL RD
Second Line	:
City	:	REISTERSTOWN
State	:	MD
Zip	:	21136-1401
Country	:	US
Telephone Number	:	410-833-3267
Fax Number	:

Provider Business Practice Location Address
First Line	:	7201 ROSSVILLE BLVD
Second Line	:	PHYSICAL EDUCATION BUILDING D
City	:	BALTIMORE
State	:	MD
Zip	:	21237-3855
Country	:	US
Telephone Number	:	410-780-6764
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	07/08/2007

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