Provider Demographics
NPI:1568437291
Name:HERMAN, PHILIP H (AT,C)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:H
Last Name:HERMAN
Suffix:
Gender:M
Credentials:AT,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 BRANCH LAKE DR
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-7535
Mailing Address - Country:US
Mailing Address - Phone:517-238-5747
Mailing Address - Fax:
Practice Address - Street 1:275 N FREMONT ST
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-1206
Practice Address - Country:US
Practice Address - Phone:517-279-5930
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer