Provider Demographics
NPI:1275650848
Name:FALCONER, SHERRI R (PT)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:R
Last Name:FALCONER
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 1:7300 E INDIANA ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-2794
Mailing Address - Country:US
Mailing Address - Phone:812-476-0409
Mailing Address - Fax:812-476-1016
Practice Address - Street 1:5011 WASHINGTON AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-4865
Practice Address - Country:US
Practice Address - Phone:812-759-7457
Practice Address - Fax:812-759-7487
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003023605225100000X
IN05007210A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist