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General NPI Number Information
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NPI Number | 1992592562
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Entity Type | Individual
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Provider Name | NICHOLAS HERRIN PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 04/24/2025
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 1490 N FAIRFIELD RD STE F
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City | BEAVERCREEK
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State | OH
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Zip | 45432-2680
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Country | US
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Telephone | 937-367-8624
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Fax | 937-783-7746
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Provider Business Mailing Address
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Address Line | 2830 ROCKLEDGE TRL
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City | BEAVERCREEK
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State | OH
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Zip | 45430-1959
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Country | US
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Telephone | 937-367-8624
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Fax | 937-783-7746
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT015316
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License Number State | OH
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