Healthcare Provider Details
I. General information
NPI: 1770584575
Provider Name (Legal Business Name): ELMER CURTIS HARRIS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/03/2005
Last Update Date: 07/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1025 N MAIN ST
FRANKLIN IN
46131-1240
US
IV. Provider business mailing address
1025 N MAIN ST
FRANKLIN IN
46131-1240
US
V. Phone/Fax
- Phone: 317-736-7088
- Fax: 317-736-8351
- Phone: 317-736-7088
- Fax: 317-736-8351
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NS0005X |
| Taxonomy | Sports Physician Chiropractor |
| License Number | 08001207 |
| License Number State | IN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 08001207 |
| License Number State | IN |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 4046 |
| License Number State | KY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: