Provider Demographics
NPI:1609251487
Name:NORRIS, SHERRY L (LMT)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:L
Last Name:NORRIS
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 1:11685 N COUNTY ROAD 25 W
Mailing Address - Street 2:
Mailing Address - City:FARMERSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47850-8271
Mailing Address - Country:US
Mailing Address - Phone:812-208-0838
Mailing Address - Fax:
Practice Address - Street 1:11685 N COUNTY ROAD 25 W
Practice Address - Street 2:
Practice Address - City:FARMERSBURG
Practice Address - State:IN
Practice Address - Zip Code:47850-8271
Practice Address - Country:US
Practice Address - Phone:812-208-0838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INMT21304956225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist