Individual
BARRY HERDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
2728 E KANTZ DR, #5, FAYETTEVILLE, AR 72703-3211
(785) 766-8187
Mailing address
2728 E KANTZ DR, #5, FAYETTEVILLE, AR 72703-3211
(785) 766-8187
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A 802
AR
Other
Enumeration date
08/04/2014
Last updated
08/04/2014
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