Provider Demographics
NPI:1629284146
Name:HERRMANN, REBECCA (DC)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:
Last Name:HERRMANN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240B ELM ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-2960
Mailing Address - Country:US
Mailing Address - Phone:617-666-3481
Mailing Address - Fax:
Practice Address - Street 1:240B ELM ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-2960
Practice Address - Country:US
Practice Address - Phone:617-666-3481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1363111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor