Provider Demographics
NPI:1598299497
Name:SHERMAN, KREG DALE II (DC)
Entity Type:Individual
Prefix:DR
First Name:KREG
Middle Name:DALE
Last Name:SHERMAN
Suffix:II
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 1:8343 SAN MARCOS
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-1020
Mailing Address - Country:US
Mailing Address - Phone:989-780-0144
Mailing Address - Fax:
Practice Address - Street 1:9138 BONITA BEACH RD SE
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-4291
Practice Address - Country:US
Practice Address - Phone:239-908-9762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12160111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor