Provider Demographics
NPI:1639535859
Name:POWER, SHARI LYNN
Entity Type:Individual
Prefix:MRS
First Name:SHARI
Middle Name:LYNN
Last Name:POWER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:IN
Mailing Address - Zip Code:46580-3313
Mailing Address - Country:US
Mailing Address - Phone:574-267-7051
Mailing Address - Fax:574-268-0008
Practice Address - Street 1:725 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:IN
Practice Address - Zip Code:46580-3313
Practice Address - Country:US
Practice Address - Phone:574-267-7051
Practice Address - Fax:574-268-0008
Is Sole Proprietor?:No
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INMT20900711225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist