Individual
BRYAN LEE HERDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.T.
Contact information
Practice address
7971 MOORSBRIDGE RD, PORTAGE, MI 49024-4075
(269) 321-0929
(269) 321-1767
Mailing address
7971 MOORSBRIDGE RD, PORTAGE, MI 49024-4075
(269) 321-0929
(269) 321-1767
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201005556
MI
Other
Enumeration date
05/02/2007
Last updated
10/24/2023
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