Provider Demographics
NPI:1689780470
Name:SHERMAN, IRENE LANE (DC)
Entity Type:Individual
Prefix:DR
First Name:IRENE
Middle Name:LANE
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-1633
Mailing Address - Country:US
Mailing Address - Phone:856-881-8811
Mailing Address - Fax:856-881-9152
Practice Address - Street 1:405 N MAIN ST
Practice Address - Street 2:
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-1633
Practice Address - Country:US
Practice Address - Phone:856-881-8811
Practice Address - Fax:856-881-9152
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC03207111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor