Healthcare Provider Details

I. General information

NPI: 1679911804
Provider Name (Legal Business Name): DAVID M HERMAN DC, CCSP, CCEP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2013
Last Update Date: 03/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 LYONS RD BLDG E
DAYTON OH
45458-1857
US

IV. Provider business mailing address

1175 LYONS RD BLDG E
DAYTON OH
45458-1857
US

V. Phone/Fax

Practice location:
  • Phone: 937-404-2189
  • Fax: 937-569-4989
Mailing address:
  • Phone: 937-404-2189
  • Fax: 937-569-4989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4321
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number4656
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: