MEDICARE: HARRIS FAMILY CHIROPRACTIC

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	111N00000X	Chiropractor	DC007490L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1104972660	OTHER	PA	NPI PROVIDER NUMBER
2	0872747000	OTHER	PA	AMERIHEALTH
3	0872747000	OTHER	PA	IBC
4	0872747000	OTHER	PA	KEYSTONE

General Provider Information

NPI Number	:	1093938961
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARRIS FAMILY CHIROPRACTIC

Provider Business Mailing Address
First Line	:	753 W MAIN ST
Second Line	:
City	:	TRAPPE
State	:	PA
Zip	:	19426-1948
Country	:	US
Telephone Number	:	610-489-8645
Fax Number	:	610-489-6329

Provider Business Practice Location Address
First Line	:	753 W MAIN ST
Second Line	:
City	:	TRAPPE
State	:	PA
Zip	:	19426-1948
Country	:	US
Telephone Number	:	610-489-8645
Fax Number	:	610-489-6329

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ANDREW K HARRIS
Credential	:	DC
Telephone Number	:	610-489-8645

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	06/02/2014

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Directions to “HARRIS FAMILY CHIROPRACTIC ” Practice Location

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