Provider Demographics
NPI:1356957989
Name:SAUNDERS, SHERRYL (LMT)
Entity type:Individual
Prefix:MISS
First Name:SHERRYL
Middle Name:
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:SHERRYL
Other - Middle Name:ANN
Other - Last Name:SAUNDERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:4480H S COBB DR SE STE 387
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6958
Mailing Address - Country:US
Mailing Address - Phone:770-710-3904
Mailing Address - Fax:
Practice Address - Street 1:1018 OAK CHASE DR APT L
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-8792
Practice Address - Country:US
Practice Address - Phone:770-710-3904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT011903225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist