Healthcare Provider Details

I. General information

NPI: 1346254901
Provider Name (Legal Business Name): SHEILA DOUGHERTY HARMON DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2602 NEWTON ST
JASPER IN
47846-1330
US

IV. Provider business mailing address

2602 NEWTON ST
JASPER IN
47846-1330
US

V. Phone/Fax

Practice location:
  • Phone: 812-634-6363
  • Fax: 812-634-7373
Mailing address:
  • Phone: 812-634-6363
  • Fax: 812-634-7373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08001819A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: