Individual
KYLE DAVID HERRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2282 HAMBURG TPKE STE A, WAYNE, NJ 07470-6291
(201) 320-4737
(862) 330-3186
Mailing address
2282 HAMBURG TPKE STE A, WAYNE, NJ 07470-6291
(973) 800-4050
(862) 330-3186
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
40QA01562000
NJ
2251X0800X
Orthopedic Physical Therapist
40QA01562000
NJ
Other
Enumeration date
02/20/2015
Last updated
12/01/2020
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