Provider Demographics
NPI:1083890479
Name:SHERMAN PHYSICAL THERAPY, P.S
Entity Type:Organization
Organization Name:SHERMAN PHYSICAL THERAPY, P.S
Other - Org Name:SHERMAN PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:T
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:360-588-8075
Mailing Address - Street 1:1813 O AVE
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-2344
Mailing Address - Country:US
Mailing Address - Phone:360-588-8075
Mailing Address - Fax:
Practice Address - Street 1:1813 O AVE
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-2344
Practice Address - Country:US
Practice Address - Phone:360-588-8075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB29064Medicare PIN