MEDICARE: JAMIE HARREL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2008034884	MO

General Provider Information

NPI Number	:	1093122962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE HARREL

Provider Business Mailing Address
First Line	:	401 ADAMS ST
Second Line	:
City	:	PARK HILLS
State	:	MO
Zip	:	63601-2205
Country	:	US
Telephone Number	:	573-631-9087
Fax Number	:

Provider Business Practice Location Address
First Line	:	116 REBEL DR
Second Line	:
City	:	PARK HILLS
State	:	MO
Zip	:	63601-2508
Country	:	US
Telephone Number	:	573-431-1211
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2014
Last Update Date	:	07/12/2014

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Directions to “ JAMIE HARREL ” Practice Location

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