Provider Demographics
NPI:1437214285
Name:SLEDGE, SHERRY LEE (LMT)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:LEE
Last Name:SLEDGE
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 1:14266 N GALATEA DR APT A
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-2112
Mailing Address - Country:US
Mailing Address - Phone:480-816-3900
Mailing Address - Fax:480-836-7473
Practice Address - Street 1:16913 E ENTERPRISE DR
Practice Address - Street 2:SUITE 103
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-4608
Practice Address - Country:US
Practice Address - Phone:480-816-3900
Practice Address - Fax:480-836-7473
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT 01583174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist