Individual
MR. HERBERT PIERRE WEATHERFORD JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
12332 TEACUP WAY, INDIANAPOLIS, IN 46235-6128
(317) 702-5343
Mailing address
813 AUDUBON DR, EVANSVILLE, IN 47715-6961
(317) 252-3941
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
266539
KY
Other
Enumeration date
05/30/2012
Last updated
06/10/2021
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