Provider Demographics
NPI:1720061062
Name:SILVER, HERBERT LEONARD (PT, DSC, OCS, MBA)
Entity Type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:LEONARD
Last Name:SILVER
Suffix:
Gender:M
Credentials:PT, DSC, OCS, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 CANTON RD NE STE 100
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-7283
Mailing Address - Country:US
Mailing Address - Phone:770-792-7522
Mailing Address - Fax:770-792-7508
Practice Address - Street 1:880 CANTON RD NE STE 100
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-7283
Practice Address - Country:US
Practice Address - Phone:770-792-7522
Practice Address - Fax:770-792-7508
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-21
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002299225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist