Individual
ITALI HERRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3415 WILLIAMS DR STE 145, GEORGETOWN, TX 78628-2886
(512) 887-4544
(512) 887-4542
Mailing address
205 PEGGY DR, LIBERTY HILL, TX 78642-4459
(254) 661-3917
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2161087
TX
Other
Enumeration date
08/12/2021
Last updated
08/12/2021
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