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Alphonse H Harding
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NPI Number Detailed Information
Provider Information:
Name: | Alphonse H Harding |
Gender: | M |
Provider License Number If Given: | 1042118 |
NPI Information:
NPI: | 1831184399 |
Entity Type (Individual or Organization): |
1-ind |
Enumeration Date: | 9/12/2005 |
Last Update Date: | 5/16/2013 |
Provider Business Mailing Address:
Address: | 620 W EDISON RD SUITE 110 Mishawaka, IN 46545 |
Phone Number: | 5742581100 |
Fax Number: | 5742581101 |
Provider Business Practice Location Address:
Address: | 620 W EDISON RD SUITE 110 Mishawaka, IN 46545 |
Phone Number: | 5742581100 |
Fax Number: | 5742581101 |
Provider Taxonomy:
Primary: | 2085B0100X |
Secondary (if any): | 2085N0700X |
State: | IN |