Provider Demographics
NPI:1912218769
Name:DUBOIS, SHERI A (CMT)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:A
Last Name:DUBOIS
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 COLORADO AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:LA JUNTA
Mailing Address - State:CO
Mailing Address - Zip Code:81050-1592
Mailing Address - Country:US
Mailing Address - Phone:719-383-3503
Mailing Address - Fax:719-383-3513
Practice Address - Street 1:201 COLORADO AVE UNIT B
Practice Address - Street 2:
Practice Address - City:LA JUNTA
Practice Address - State:CO
Practice Address - Zip Code:81050-1592
Practice Address - Country:US
Practice Address - Phone:719-383-3503
Practice Address - Fax:719-383-3513
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-27
Last Update Date:2010-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT-1953172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist