Provider Demographics
NPI:1063967446
Name:HERMAN, DANIEL (DC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:HERMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6431 INKSTER RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48301-1310
Mailing Address - Country:US
Mailing Address - Phone:248-539-0100
Mailing Address - Fax:248-539-0110
Practice Address - Street 1:6431 INKSTER RD
Practice Address - Street 2:SUITE 220
Practice Address - City:BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48301-1310
Practice Address - Country:US
Practice Address - Phone:248-539-0100
Practice Address - Fax:248-539-0110
Is Sole Proprietor?:No
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010257111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor