Provider Demographics
NPI:1255544938
Name:HARRIS, JAMES WENDELL (ATC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:WENDELL
Last Name:HARRIS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 S COMMONS CIR NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44721-3219
Mailing Address - Country:US
Mailing Address - Phone:330-494-3672
Mailing Address - Fax:
Practice Address - Street 1:919 S COMMONS CIR NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44721-3219
Practice Address - Country:US
Practice Address - Phone:330-494-3672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0002872255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer