MEDICARE: JASON PAUL HARRE DC

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	2003031904	MO
2	111N00000X	Chiropractor	CH11084	FL

General Provider Information

NPI Number	:	1518002971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON PAUL HARRE DC

Provider Business Mailing Address
First Line	:	6150 DIAMOND CENTRE CT
Second Line	:	SUITE 1003
City	:	FORT MYERS
State	:	FL
Zip	:	33912-4368
Country	:	US
Telephone Number	:	239-245-7909
Fax Number	:	239-245-7981

Provider Business Practice Location Address
First Line	:	6150 DIAMOND CENTRE CT
Second Line	:	SUITE 1003
City	:	FORT MYERS
State	:	FL
Zip	:	33912-4368
Country	:	US
Telephone Number	:	239-245-7909
Fax Number	:	239-245-7981

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

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	02/17/2014

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Directions to “ JASON PAUL HARRE DC” Practice Location

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