Provider Demographics
NPI:1699969576
Name:HERMAN, JAMES ANDREW (PT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ANDREW
Last Name:HERMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3145 CLARK RD
Mailing Address - Street 2:STE 106
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-1120
Mailing Address - Country:US
Mailing Address - Phone:734-528-9760
Mailing Address - Fax:734-829-0173
Practice Address - Street 1:3145 CLARK RD
Practice Address - Street 2:STE 102
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1120
Practice Address - Country:US
Practice Address - Phone:734-528-9760
Practice Address - Fax:734-528-9761
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501010896225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist