Provider Demographics
NPI:1346424918
Name:PIERCE, SHERRI (LPTA)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:PIERCE
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 N. DIVISION
Mailing Address - Street 2:
Mailing Address - City:BRAIDWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60408
Mailing Address - Country:US
Mailing Address - Phone:815-458-6964
Mailing Address - Fax:
Practice Address - Street 1:1130 N. DIVISION
Practice Address - Street 2:
Practice Address - City:BRAIDWOOD
Practice Address - State:IL
Practice Address - Zip Code:60408
Practice Address - Country:US
Practice Address - Phone:815-458-6964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant