Provider Demographics
NPI:1205902822
Name:HERSCHER, MARC L (PT)
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:L
Last Name:HERSCHER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2799 LAWRENCEVILLE HWY
Mailing Address - Street 2:205
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-2531
Mailing Address - Country:US
Mailing Address - Phone:770-491-0920
Mailing Address - Fax:770-491-0906
Practice Address - Street 1:2799 LAWRENCEVILLE HWY
Practice Address - Street 2:205
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-2531
Practice Address - Country:US
Practice Address - Phone:770-491-0920
Practice Address - Fax:770-491-0906
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2015-12-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NCPT007547225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAPT007547Medicare Oscar/Certification