Individual
NICHOLAS KEITH BERRYMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
118 MEDICAL DR, CARMEL, IN 46032-3323
(812) 987-5098
Mailing address
918 E ELM ST, NEW ALBANY, IN 47150-3062
(812) 987-5098
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002695A
IA
Other
Enumeration date
05/13/2019
Last updated
05/13/2019
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