Provider Demographics
NPI:1679911804
Name:HERMAN, DAVID M (DC, CCSP, CCEP)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:HERMAN
Suffix:
Gender:M
Credentials:DC, CCSP, CCEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 LYONS RD BLDG E
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-1857
Mailing Address - Country:US
Mailing Address - Phone:937-404-2189
Mailing Address - Fax:937-569-4989
Practice Address - Street 1:1175 LYONS RD BLDG E
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45458-1857
Practice Address - Country:US
Practice Address - Phone:937-404-2189
Practice Address - Fax:937-569-4989
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4656111NS0005X
NC4321111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111N00000XChiropractic ProvidersChiropractor