Provider Demographics
NPI:1396881348
Name:SHERRILL, BRANDY MICHELLE (PT)
Entity type:Individual
Prefix:MS
First Name:BRANDY
Middle Name:MICHELLE
Last Name:SHERRILL
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 1:39909 DEMOY DR
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804-9674
Mailing Address - Country:US
Mailing Address - Phone:405-831-5107
Mailing Address - Fax:405-878-4792
Practice Address - Street 1:2904 PARKLAWN DRIVE
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-4232
Practice Address - Country:US
Practice Address - Phone:405-732-8900
Practice Address - Fax:405-732-1771
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3801225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist