Individual
MARK I HERRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4662 LARWELL DR, COLUMBUS, OH 43220-3621
(614) 442-6754
(614) 442-6737
Mailing address
4662 LARWELL DR, COLUMBUS, OH 43220-3621
(614) 442-6754
(614) 442-6737
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
33.5565
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33.5565
BWC
OH
Enumeration date
07/07/2022
Last updated
07/07/2022
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