Provider Demographics
NPI:1952492340
Name:HERRMANN, PATRICIA A (DC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:A
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 1:616 EAGLES LANDING PKWY # 10
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-5096
Mailing Address - Country:US
Mailing Address - Phone:678-565-1500
Mailing Address - Fax:678-565-7411
Practice Address - Street 1:616 EAGLES LANDING PKWY # 10
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-5096
Practice Address - Country:US
Practice Address - Phone:678-565-1500
Practice Address - Fax:678-565-7411
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR6712111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA6419780001Medicare NSC
GAU84329Medicare UPIN
GA35ZCHGGMedicare PIN