Provider Information for 1467724294
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HARVEY NORRIS
Gender: Male
NPI: 1467724294
Last Updated: 2013-05-24
Certification Date:
Certification Date:
Details
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NPI | 1467724294 | ||||||||
Enumeration Date | 2012-02-09 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
Mailing Address | 6606 MONROE HWY BALL, LA 71405-3226 United States Phone: 850-508-8104 | Fax:866-399-5815 | ||||||||
Primary Practice Address | 2495 SHREVEPORT HWY BUILDING 3, ROOM 115, SERVICE 122 PINEVILLE, LA 71360-4044 United States Phone: 800-375-8387 | Fax:866-399-5915 | ||||||||
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