Provider Demographics
NPI:1376090084
Name:SHERMAN, SHAWN ALONZO (ATC)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:ALONZO
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8001 33RD AVE SOUTH
Mailing Address - Street 2:UNIT D-463
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425
Mailing Address - Country:US
Mailing Address - Phone:612-708-2382
Mailing Address - Fax:
Practice Address - Street 1:8001 33RD AVE S UNIT D463
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-4639
Practice Address - Country:US
Practice Address - Phone:612-708-2382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer