Provider Demographics
NPI:1891385142
Name:PLUMMER, SHERYL (LMT)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:
Last Name:PLUMMER
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 1:340 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:46160-9763
Mailing Address - Country:US
Mailing Address - Phone:765-318-7038
Mailing Address - Fax:
Practice Address - Street 1:340 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:IN
Practice Address - Zip Code:46160-9763
Practice Address - Country:US
Practice Address - Phone:765-318-7038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INMT20900736225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist