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Individual

AUSTIN HERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
552 BEACON LAKE DR, APT 8, MASON, MI 48854-1968
(269) 986-5019
Mailing address
552 BEACON LAKE DR, APT 8, MASON, MI 48854-1968

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2000022987
SPECIALIST/TECHNOLOGIST/ATHLETIC TRAINER
MI
Enumeration date
01/26/2015
Last updated
03/17/2016
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