Provider Demographics
NPI:1073712196
Name:SHERRICK, PHILIP MAURICE JR (OTR/L, CHT)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:MAURICE
Last Name:SHERRICK
Suffix:JR
Gender:M
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11969 E KANSAS AVE
Mailing Address - Street 2:
Mailing Address - City:RILEY
Mailing Address - State:KS
Mailing Address - Zip Code:66531-9666
Mailing Address - Country:US
Mailing Address - Phone:785-643-1517
Mailing Address - Fax:
Practice Address - Street 1:315 S SETH CHILD RD
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-3003
Practice Address - Country:US
Practice Address - Phone:785-643-1517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist