Provider Demographics
NPI:1407988512
Name:SHERMAN CHIROPRACTIC AND REHABILITATION
Entity Type:Organization
Organization Name:SHERMAN CHIROPRACTIC AND REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:507-532-3803
Mailing Address - Street 1:902 W COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MN
Mailing Address - Zip Code:56258-1673
Mailing Address - Country:US
Mailing Address - Phone:507-532-3803
Mailing Address - Fax:507-532-3805
Practice Address - Street 1:902 W COLLEGE DR
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-1673
Practice Address - Country:US
Practice Address - Phone:507-532-3803
Practice Address - Fax:507-532-3805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNDC3861111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN27G84SHOtherBCBS
MN22414OtherSVHP
MN27G84SHOtherBCBS