Provider Demographics
NPI:1356357263
Name:MASON, SHERRY (PT)
Entity type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:
Last Name:MASON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044-6055
Mailing Address - Country:US
Mailing Address - Phone:405-282-7099
Mailing Address - Fax:
Practice Address - Street 1:302 ALLEN RD
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044-6055
Practice Address - Country:US
Practice Address - Phone:405-282-7099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor