MEDICARE: DR. DENNIS RAY HARRIS 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	DC002517L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780689372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS RAY HARRIS DC

Provider Business Mailing Address
First Line	:	80 FRALEY ST
Second Line	:
City	:	KANE
State	:	PA
Zip	:	16735-1325
Country	:	US
Telephone Number	:	814-837-6493
Fax Number	:	814-837-6493

Provider Business Practice Location Address
First Line	:	80 FRALEY ST
Second Line	:
City	:	KANE
State	:	PA
Zip	:	16735-1325
Country	:	US
Telephone Number	:	814-837-6493
Fax Number	:	814-837-6493

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	08/26/2013

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Directions to “ DR. DENNIS RAY HARRIS DC” Practice Location

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