Provider Demographics
NPI:1194038190
Name:HARRIS, SALVIA ACOSTA (LMP)
Entity type:Individual
Prefix:
First Name:SALVIA
Middle Name:ACOSTA
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:SALVIA
Other - Middle Name:SHERMAN
Other - Last Name:MAKEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SALVIA SHERMAN MAKEE
Mailing Address - Street 1:1201 US HIGHWAY 10 W STE A1
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:MT
Mailing Address - Zip Code:59047-9022
Mailing Address - Country:US
Mailing Address - Phone:406-272-5270
Mailing Address - Fax:
Practice Address - Street 1:1201 US HIGHWAY 10 W
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:MT
Practice Address - Zip Code:59047-9022
Practice Address - Country:US
Practice Address - Phone:406-272-5270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-19
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALMT-LMT-LIC-11837246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other