Provider Information for 1902472301
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WILLIAM ROBERTS HERKELRATH
Sex: Male
NPI: 1902472301
Last Updated: 2024-11-25
Certification Date: 2024-11-25
Certification Date: 2024-11-25
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1902472301 | ||||||||
| Enumeration Date | 2021-05-27 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1038 REDWOOD HWY FRONTAGE RD STE 1 MILL VALLEY, CA 94941-1620 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 1038 REDWOOD HWY FRONTAGE RD STE 1 MILL VALLEY, CA 94941-1620 United States Phone: 801-562-4484 | Fax: | ||||||||
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