Provider Demographics
NPI:1063175222
Name:HARRIS, FRANK WRIGHT V (LAC)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:WRIGHT
Last Name:HARRIS
Suffix:V
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 E ADELAIDE DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-2604
Mailing Address - Country:US
Mailing Address - Phone:520-609-8488
Mailing Address - Fax:
Practice Address - Street 1:2450 E SPEEDWAY BLVD STE 6
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-4748
Practice Address - Country:US
Practice Address - Phone:520-609-8488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-010717171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist