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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

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