Provider Demographics
NPI:1326075508
Name:HERRMANN, STEVEN O (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:O
Last Name:HERRMANN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 E 8TH ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-3079
Mailing Address - Country:US
Mailing Address - Phone:616-393-8485
Mailing Address - Fax:616-393-8494
Practice Address - Street 1:720 E 8TH ST
Practice Address - Street 2:SUITE 3
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-3079
Practice Address - Country:US
Practice Address - Phone:616-393-8485
Practice Address - Fax:616-393-8494
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007141111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M51880Medicare ID - Type Unspecified
MIU68517Medicare UPIN