Provider Demographics
NPI:1700944386
Name:LASHOMB, SHERRI L (DC ATC)
Entity Type:Individual
Prefix:DR
First Name:SHERRI
Middle Name:L
Last Name:LASHOMB
Suffix:
Gender:F
Credentials:DC ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 CENTER STREET
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:NY
Mailing Address - Zip Code:14092
Mailing Address - Country:US
Mailing Address - Phone:716-754-7400
Mailing Address - Fax:716-754-1173
Practice Address - Street 1:765 CENTER STREET
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:NY
Practice Address - Zip Code:14092
Practice Address - Country:US
Practice Address - Phone:716-754-7400
Practice Address - Fax:716-754-1173
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0056971111N00000X
NYX0056972111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY252261OtherBLUE CROSS BLUE SHIELD
NY8809248OtherINDEPENT HEALTH ASSOC
U02480Medicare UPIN
NY8809248OtherINDEPENT HEALTH ASSOC