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NPI Code Detail

MEDICARE: MR. HAROLD DEAN SCHARBOR L.M.T.

MEDICARE: MR. HAROLD DEAN SCHARBOR L.M.T.
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
1225700000XMassage Therapist1463AR

General Provider Information

NPI Number : 1316065329
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. HAROLD DEAN SCHARBOR L.M.T.
Provider Business Mailing Address
First Line : 6108 SOUTH 31STREET
Second Line :
City : FORT SMITH
State : AR
Zip : 72908
Country : US
Telephone Number : 479-648-1107
Fax Number :
Provider Business Practice Location Address
First Line : 6108 S 31ST ST
Second Line :
City : FORT SMITH
State : AR
Zip : 72908-7555
Country : US
Telephone Number : 479-648-1107
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2007
Last Update Date : 07/08/2007

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