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NPI Code Detail

MEDICARE: MR. PARAM HARRIS PTA

MEDICARE: MR. PARAM HARRIS PTA
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
1225200000XPhysical Therapy Assistant1238WV

General Provider Information

NPI Number : 1578764700
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PARAM HARRIS PTA
Provider Business Mailing Address
First Line : 301A PIKE ST
Second Line :
City : COAL GROVE
State : OH
Zip : 45638-3135
Country : US
Telephone Number : 740-357-5338
Fax Number :
Provider Business Practice Location Address
First Line : 300 SEVILLE RD
Second Line :
City : HURRICANE
State : WV
Zip : 25526-9206
Country : US
Telephone Number : 304-757-6805
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2007
Last Update Date : 07/08/2007

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