Clyde Wesley Herndon PT

NPI 1013092477 - Physical Therapist - 225100000X

NPI Details
NPI 1013092477
Gender Male
Enumeration Date 10/26/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
106 SHOPPERS WAY
STE G
BRUNSWICK GA, 31525, US
Phone (912) 280-0600
Fax
Business Location
PO BOX 357
BRUNSWICK GA, 31521-0357, US
Phone (912) 280-0600
Fax
Toxanomy
Taxonomy Code 225100000X
License State Georgia
License Number PT002875
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According to our database, Clyde Wesley Herndon PT NPI is 1013092477, taxonomy code is 225100000X and license number is PT002875, license state is located at Georgia. Clyde Wesley Herndon PT physically located at 106 Shoppers Way, Brunswick GA, 31525. NPI Number Clyde Wesley Herndon PT has the Individual type.

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1013092477 NPI number is provided on an as is basis without warranty of any kind. 1013092477 is maintained by the National Plan & Provider Enumeration System. The contents of Clyde Wesley Herndon PT are for informational purposes only.