Provider Demographics
NPI:1053617480
Name:FRANK, HARRIS SAMUEL (LAC)
Entity type:Individual
Prefix:MR
First Name:HARRIS
Middle Name:SAMUEL
Last Name:FRANK
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
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Mailing Address - Street 1:4000 SHAKERAG HL STE 300
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-4047
Mailing Address - Country:US
Mailing Address - Phone:770-756-1979
Mailing Address - Fax:855-393-9876
Practice Address - Street 1:4000 SHAKERAG HL STE 300
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-4047
Practice Address - Country:US
Practice Address - Phone:770-756-1979
Practice Address - Fax:855-393-9876
Is Sole Proprietor?:No
Enumeration Date:2011-02-02
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13434171100000X
GA314171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist