Provider Demographics
NPI:1316053473
Name:HERBERT, ANN MARIE (MPT OCS)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:MARIE
Last Name:HERBERT
Suffix:
Gender:F
Credentials:MPT OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2008 HOGBACK ROAD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9751
Mailing Address - Country:US
Mailing Address - Phone:734-971-9790
Mailing Address - Fax:734-971-1360
Practice Address - Street 1:2008 HOGBACK ROAD
Practice Address - Street 2:SUITE 3
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9751
Practice Address - Country:US
Practice Address - Phone:734-971-9790
Practice Address - Fax:734-971-1360
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501008731225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist