Mark Scott Herbert

NPI #1003178807 in Shawano, Wisconsin

Provider Information

NPI Number: 1003178807
Entity Type: Individual
Name: Mark Scott Herbert
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Enumeration Date: Jun 8, 2012
Last Updated: Jun 8, 2012

Practice Location

Address: N4231 STATE HIGHWAY 22
City: Shawano
State: Wisconsin
ZIP Code: 54166-6130
Phone: (715) 526-3158

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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