Kenneth Wayne Harbour, R.R.A, R.T.(R)
Radiology Practitioner Assistant in Gainesville, FL. Individual provider (NPI-1).
NPI number1124385877
StatusActive
Last updated in NPPESApr 19, 2012
Details
- NPI
- 1124385877
- Entity type
- Individual (NPI-1)
- Name
- Mr. Kenneth Wayne Harbour
- Credential
- R.R.A, R.T.(R)
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 19, 2012
- Last updated
- Apr 19, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 243U00000X | Radiology Practitioner Assistant | RA28 | FL | Yes |
| 243U00000X | Radiology Practitioner Assistant | CRT54343 | FL |
Practice location
1600 Sw Archer RdGainesville, FL 32610-3003
Phone 352-265-0111
Mailing address
649 Turkey CrkAlachua, FL 32615-9309
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