Provider Demographics
NPI:1255399713
Name:JOHNSTON, SHERRI ADELE (ATC)
Entity type:Individual
Prefix:MRS
First Name:SHERRI
Middle Name:ADELE
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1986 MICHAEL DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-2730
Mailing Address - Country:US
Mailing Address - Phone:423-926-7617
Mailing Address - Fax:
Practice Address - Street 1:11802 BRINLEY AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-1089
Practice Address - Country:US
Practice Address - Phone:502-244-2774
Practice Address - Fax:502-244-8085
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer