Individual
CARRIE HERRMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3605 COLLEGE AVE, CONWAY, AR 72034-7377
(501) 327-2235
Mailing address
2100 W MAIN ST, RUSSELLVILLE, AR 72801-2758
(479) 968-2525
(479) 968-2538
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5030
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0444861
WASHINGTON DOL
—
05
—
275978721
—
AR
Enumeration date
09/30/2021
Last updated
06/22/2022
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