Healthcare Provider Details

I. General information

NPI: 1558105320
Provider Name (Legal Business Name): PETER HARRIS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2024
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1675 BRIARGATE BLVD STE B
COLORADO SPRINGS CO
80920-3416
US

IV. Provider business mailing address

1675 BRIARGATE BLVD STE B
COLORADO SPRINGS CO
80920-3416
US

V. Phone/Fax

Practice location:
  • Phone: 719-247-6227
  • Fax:
Mailing address:
  • Phone: 860-916-9730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number0008607
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: