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General NPI Number Information
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NPI Number | 1669555041
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Entity Type | Individual
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Provider Name | BRYSON CARROLL HARRIS D.P.T.
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Gender | Male
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | RR 6 BOX 840
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City | STILWELL
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State | OK
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Zip | 74960-8703
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Country | US
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Telephone | 919-696-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 57 NORTHAVEN ST
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City | FARMINGTON
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State | AR
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Zip | 72730-9719
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Country | US
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Telephone | 479-267-5102
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2842
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License Number State | AR
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