Provider Demographics
NPI:1881206332
Name:HERMAN, JULIAN R
Entity Type:Individual
Prefix:MISS
First Name:JULIAN
Middle Name:R
Last Name:HERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 302
Mailing Address - Street 2:
Mailing Address - City:GNADENHUTTEN
Mailing Address - State:OH
Mailing Address - Zip Code:44629-0302
Mailing Address - Country:US
Mailing Address - Phone:864-506-6197
Mailing Address - Fax:
Practice Address - Street 1:453 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-2205
Practice Address - Country:US
Practice Address - Phone:614-292-1706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer