MEDICARE: SUSAN HARBISON

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	246ZE0600X	Electroneurodiagnostic Specialist/Technologist

General Provider Information

NPI Number	:	1811311228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN HARBISON

Provider Business Mailing Address
First Line	:	7220 W JEFFERSON AVE
Second Line	:	SUITE 305
City	:	LAKEWOOD
State	:	CO
Zip	:	80235-2031
Country	:	US
Telephone Number	:	303-984-1856
Fax Number	:	303-922-4640

Provider Business Practice Location Address
First Line	:	7220 W JEFFERSON AVE
Second Line	:	SUITE 305
City	:	LAKEWOOD
State	:	CO
Zip	:	80235-2031
Country	:	US
Telephone Number	:	303-984-1856
Fax Number	:	303-922-4640

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

Provider Enumeration Date	:	02/06/2014
Last Update Date	:	06/08/2015

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Directions to “ SUSAN HARBISON ” Practice Location

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