Most Relevant Information
Provider Data
| NPI Number: | 1003267717 |
| Provider Name: | DEVONJA HARRIS |
| Entity Type: | Individual |
| Taxonomy Code: | 247200000X |
| Specialty: | Technician, Other |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/23/2016 |
| Last Updated: | 06/23/2016 |
Provider Practice Location
539 E CHESTER ST
JACKSON
TN
383017062
Practice Location Phone/Fax
| Phone: | 7314236900 |
| Fax: | 7312141816 |
Provider Mailing Location
PO BOX 12432
JACKSON
TN
383080141
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |