Individual
EVAN R. HERDEMAN
Active
Individual
EVAN R. HERDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
013062
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000685484
ANTHEM
OH
05
—
3123551
—
OH
Enumeration date
10/05/2010
Last updated
09/23/2013
Update your record
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