Provider Demographics
NPI:1346508553
Name:SHERMAN, RENNEIL KIRKPATRICK (DC)
Entity Type:Individual
Prefix:
First Name:RENNEIL
Middle Name:KIRKPATRICK
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7128 W MCNAB RD
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-5306
Mailing Address - Country:US
Mailing Address - Phone:517-862-8848
Mailing Address - Fax:
Practice Address - Street 1:7128 W MCNAB RD
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-5306
Practice Address - Country:US
Practice Address - Phone:954-720-3002
Practice Address - Fax:954-720-3004
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-25
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10563111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor