Provider Demographics
NPI:1831153923
Name:HERR, VICKI DIANE (PT)
Entity type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:DIANE
Last Name:HERR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3833 ATTUCKS DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-6082
Mailing Address - Country:US
Mailing Address - Phone:614-793-8720
Mailing Address - Fax:614-793-8722
Practice Address - Street 1:3833 ATTUCKS DR
Practice Address - Street 2:SUITE B
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-6082
Practice Address - Country:US
Practice Address - Phone:614-793-8720
Practice Address - Fax:614-793-8722
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0034742251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics