Provider Demographics
NPI:1992400931
Name:HARRIS, CHLOE BELLE
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:BELLE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHLOE
Other - Middle Name:
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LAT, ATC
Mailing Address - Street 1:1241 KINZER LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-5725
Mailing Address - Country:US
Mailing Address - Phone:931-626-4626
Mailing Address - Fax:
Practice Address - Street 1:1241 KINZER LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-5725
Practice Address - Country:US
Practice Address - Phone:931-626-4626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-31
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20000561902255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer