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Individual
LARA KRISTINE HERZOG
Active
Individual
LARA KRISTINE HERZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
038070
NY
225100000X
Physical Therapist
10948
TN
225100000X
Physical Therapist
7537
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05899665
—
NY
Enumeration date
11/26/2014
Last updated
04/14/2021
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