Provider Demographics
NPI:1275605214
Name:LUNDQUIST, SHERRI M (PT)
Entity Type:Individual
Prefix:MRS
First Name:SHERRI
Middle Name:M
Last Name:LUNDQUIST
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3873 SEVEN DIALS CT
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-4193
Mailing Address - Country:US
Mailing Address - Phone:770-565-5632
Mailing Address - Fax:770-565-7991
Practice Address - Street 1:3873 SEVEN DIALS CT
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-4193
Practice Address - Country:US
Practice Address - Phone:770-565-5632
Practice Address - Fax:770-565-7991
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0029282251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics