Healthcare Provider Details

I. General information

NPI: 1104778679
Provider Name (Legal Business Name): KATHERINE HARMON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 E 4TH ST
ELDON MO
65026-1838
US

IV. Provider business mailing address

5128 SHADY LN
JEFFERSON CITY MO
65109-0480
US

V. Phone/Fax

Practice location:
  • Phone: 573-557-2311
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2026005246
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: