Individual
EVAN R. HERDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4440 GLEN ESTE WITHAMSVILLE RD, CINCINNATI, OH 45245-1318
(513) 943-3630
(513) 753-4308
Mailing address
4440 GLEN ESTE WITHAMSVILLE RD, CINCINNATI, OH 45245-1318
(513) 943-3630
(513) 753-4308
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
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