| Doctor Name: | JEREMY E HARRIS |
| NPI Number: | 1083896807 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | BOCP |
| License Number: | C22326 |
| Business Practice Address: | 1108 Peninsula Dr Gallatin, TN - 370663819 |
| Business Phone Number: | 2708165888 |
| Business Fax Number: | |
| Mailing Address: | 1108 Peninsula Dr, GALLATIN |
| State: | TN |
| Postal Code: | 370663819 |
| Phone Number: | 2708165888 |
| Fax Number: | |
| NPI Enumeration Date: | 12/04/2007 |
| NPI Last Update Date: | 05/19/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | C22326 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |