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General NPI Number Information
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NPI Number | 1205719838
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Entity Type | Individual
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Provider Name | ROBERT THOMAS HARRIS AT STUDENT
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Gender | Male
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Dates
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Enumeration Date | 07/30/2025
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 2087 ACORN BLVD
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City | FRANKLIN
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State | IN
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Zip | 46131-7306
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Country | US
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Telephone | 317-738-8095
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Fax |
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Provider Business Mailing Address
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Address Line | 10010 HIGHWAY 362
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City | NABB
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State | IN
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Zip | 47147-9749
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Country | US
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Telephone | 502-689-1504
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State | IN
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