Provider Demographics
NPI:1194028316
Name:COX, SHERRY LYNN (LMT #6551)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:LYNN
Last Name:COX
Suffix:
Gender:F
Credentials:LMT #6551
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5812 POJOAQUE RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-2052
Mailing Address - Country:US
Mailing Address - Phone:505-319-3506
Mailing Address - Fax:
Practice Address - Street 1:5812 POJOAQUE RD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-2052
Practice Address - Country:US
Practice Address - Phone:505-319-3506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-09
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM6551225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist