Provider Demographics
NPI:1346914298
Name:FREELAND, SHERRY (LMT)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:FREELAND
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 ALPINE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:TERRA ALTA
Mailing Address - State:WV
Mailing Address - Zip Code:26764-7743
Mailing Address - Country:US
Mailing Address - Phone:304-698-8494
Mailing Address - Fax:
Practice Address - Street 1:114 ALPINE LAKE RD
Practice Address - Street 2:
Practice Address - City:TERRA ALTA
Practice Address - State:WV
Practice Address - Zip Code:26764-7743
Practice Address - Country:US
Practice Address - Phone:304-777-0958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2021-3858225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty