Provider Demographics
NPI:1194263889
Name:HARMAN, JEFFREY ROBERT (LAT, ATC)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:ROBERT
Last Name:HARMAN
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 PARK CIR
Mailing Address - Street 2:APT. A
Mailing Address - City:CLARION
Mailing Address - State:PA
Mailing Address - Zip Code:16214-1777
Mailing Address - Country:US
Mailing Address - Phone:717-307-0195
Mailing Address - Fax:
Practice Address - Street 1:407 PARK CIR
Practice Address - Street 2:APT. A
Practice Address - City:CLARION
Practice Address - State:PA
Practice Address - Zip Code:16214-1777
Practice Address - Country:US
Practice Address - Phone:717-307-0195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0063332255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer