Individual
CHARLES HERBERT
Active
Individual
CHARLES HERBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3741
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000Q0406
—
NM
01
—
1245380039
BERNALILLO FACILITY NPI
NM
01
—
1386651412
BILLING NPI
NM
Enumeration date
09/02/2009
Last updated
04/19/2010
Update your record
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