=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497199749
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERIN S HARRISON DPT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/17/2013
-----------------------------------------------------
Last Update Date | 09/26/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 203 OAK ST
-----------------------------------------------------
City | NATICK
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01760-1306
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-651-0051
-----------------------------------------------------
Fax | 508-651-0061
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 600 OAKMONT LN STE 600C
-----------------------------------------------------
City | WESTMONT
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60559-5548
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-651-0051
-----------------------------------------------------
Fax | 508-651-0061
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 070.024733
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 20425
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------