Provider Demographics
NPI:1508324641
Name:SHERMAN, MICHAEL HAKE JR (PTA)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:HAKE
Last Name:SHERMAN
Suffix:JR
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 HYUNDAI BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36105-9608
Mailing Address - Country:US
Mailing Address - Phone:334-387-8641
Mailing Address - Fax:
Practice Address - Street 1:900 HYUNDAI BLVD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36105-9608
Practice Address - Country:US
Practice Address - Phone:334-387-8641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant