Provider Demographics
NPI:1366442709
Name:BEATTY, SHERWOOD AUSTIN (DC)
Entity Type:Individual
Prefix:DR
First Name:SHERWOOD
Middle Name:AUSTIN
Last Name:BEATTY
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 1:39 CHADBURN RD
Mailing Address - Street 2:
Mailing Address - City:BARTON
Mailing Address - State:VT
Mailing Address - Zip Code:05822-9552
Mailing Address - Country:US
Mailing Address - Phone:802-754-2539
Mailing Address - Fax:802-754-6910
Practice Address - Street 1:39 CHADBURN RD
Practice Address - Street 2:
Practice Address - City:BARTON
Practice Address - State:VT
Practice Address - Zip Code:05822-9552
Practice Address - Country:US
Practice Address - Phone:802-754-2539
Practice Address - Fax:802-754-6910
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT006001047111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor