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General NPI Number Information
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NPI Number | 1942946488
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Entity Type | Individual
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Provider Name | KELLY HARRIS ATC
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Gender | Female
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Dates
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Enumeration Date | 05/09/2022
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Last Update Date | 05/09/2022
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Provider Practice Location Address
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Address Line | 1300 BRUSHY CREEK RD
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City | TAYLORS
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State | SC
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Zip | 29687-4095
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Country | US
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Telephone | 864-355-2829
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Fax |
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Provider Business Mailing Address
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Address Line | 403 WINDWARD WAY
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City | GREER
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State | SC
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Zip | 29650-3837
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Country | US
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Telephone | 540-250-7061
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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 | 174H00000X
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Taxonomy Name | Health Educator
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License Number | 975
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License Number State | SC
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