Healthcare Provider Details

I. General information

NPI: 1760417067
Provider Name (Legal Business Name): ROBERT DAVID HARMON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 11/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

186 SUMMER ST
KINGSTON MA
02364-1282
US

IV. Provider business mailing address

1 CREDIT UNION WAY FL 3
RANDOLPH MA
02368-4633
US

V. Phone/Fax

Practice location:
  • Phone: 781-679-2999
  • Fax: 781-585-1279
Mailing address:
  • Phone: 781-961-3370
  • Fax: 781-961-1291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2869
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: