Provider Demographics
NPI:1093098865
Name:DAWKINS, SHERITA GENA
Entity Type:Individual
Prefix:
First Name:SHERITA
Middle Name:GENA
Last Name:DAWKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 CUMBERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-3329
Mailing Address - Country:US
Mailing Address - Phone:615-957-6914
Mailing Address - Fax:615-859-0506
Practice Address - Street 1:1620 WAYNE RD
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:TN
Practice Address - Zip Code:38372-1548
Practice Address - Country:US
Practice Address - Phone:731-925-4004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000008529225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist