Provider Demographics
NPI:1023473725
Name:HARRIS, KARI LYNN (DPT, MPT)
Entity type:Individual
Prefix:MRS
First Name:KARI
Middle Name:LYNN
Last Name:HARRIS
Suffix:
Gender:F
Credentials:DPT, MPT
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:LYNN
Other - Last Name:DREVECKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:4723 BOULDER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-6124
Mailing Address - Country:US
Mailing Address - Phone:701-751-6371
Mailing Address - Fax:701-323-6907
Practice Address - Street 1:225 N 7TH ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4417
Practice Address - Country:US
Practice Address - Phone:701-323-6837
Practice Address - Fax:701-323-6907
Is Sole Proprietor?:No
Enumeration Date:2015-12-22
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND0953225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist