Healthcare Provider Details

I. General information

NPI: 1730119033
Provider Name (Legal Business Name): ANDREW DEAN HARRIS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 12/19/2019
Certification Date: 12/19/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

294 NORTH NC 16 STE. B
DENVER NC
28117
US

IV. Provider business mailing address

123 WILTON PL
MOORESVILLE NC
28117-4356
US

V. Phone/Fax

Practice location:
  • Phone: 980-222-2683
  • Fax:
Mailing address:
  • Phone: 423-741-0191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2337
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: