Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 08312 | LA |
NPI | 1093066029 |
---|---|
Provider Name | Daniel Patrick Herring |
First Address | Baton Rouge, LA 70806-6530 |
Second Address | Baton Rouge, LA 70806-6530 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2012 |
Last Update Date | 23/06/2016 |