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General NPI Number Information
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NPI Number | 1407841919
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Entity Type | Individual
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Provider Name | MILTON PAUL HERMAN OD
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Gender | Male
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Dates
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Enumeration Date | 09/12/2005
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Last Update Date | 10/30/2008
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Provider Practice Location Address
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Address Line | 117 GLOVER ST.
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City | TWISP
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State | WA
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Zip | 98856
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Country | US
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Telephone | 509-997-5201
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Fax | 509-997-5202
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Provider Business Mailing Address
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Address Line | 117 GLOVER ST.
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City | TWISP
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State | WA
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Zip | 98856-0578
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Country | US
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Telephone | 509-997-5201
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Fax | 509-997-5202
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1043 TX
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License Number State | WA
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