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NPI Code Detail

MEDICARE: DEAN MICHAEL HARRISON MS,LAT,ATC

MEDICARE: DEAN MICHAEL HARRISON MS,LAT,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
12255A2300XAthletic TrainerAT8466TX
22255A2300XAthletic TrainerAT8522TX
32255A2300XAthletic TrainerLAT-5302NC

General Provider Information

NPI Number : 1689262644
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEAN MICHAEL HARRISON MS,LAT,ATC
Provider Business Mailing Address
First Line : 606 W HARNETT ST
Second Line :
City : BENSON
State : NC
Zip : 27504-1644
Country : US
Telephone Number : 904-600-7004
Fax Number :
Provider Business Practice Location Address
First Line : 2817 REILLY ST
Second Line :
City : FORT BRAGG
State : NC
Zip : 28310-9361
Country : US
Telephone Number : 910-907-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2021
Last Update Date : 10/06/2025

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